The most common cause of hearing loss in children is middle ear infection (otitis media). This is an infection in the space behind the eardrum and usually stems from a cold-related complication. It can occur in one or both ears. Most ear infections are due to viruses that are sometimes secondarily infected by bacteria. They can usually be treated without the aid of antibiotics.
Middle ear infection can cause earache, which is due to reduced pressure within the middle ear from a blocked eustachian tube (tubes which drain the ears into the back of the throat) or from inflammation of the middle ear tissues. It may impair learning capacity and sometimes delay speech development. However, if the infection is managed effectively, hearing can almost always be restored to normal.
Likely causes
A cold or upper respiratory infection can cause blockage in the eustachian tube. This, along with the presence of bacteria, can lead to a build-up of fluid (pus and mucus) behind the ear drum, resulting in acute otitis media. The build-up of pus in the middle ear causes swelling, redness and earache and can cause hearing problems. Often after an acute infection has passed there may be frequent recurrences of the infection for months or years later, causing difficulty in hearing. This can be successfully treated with analgesics. Sometimes decongestive nose drops to 'open up' the eustachian tube can help.
Sometimes the ear drum can perforate, resulting in infected discharge from the ear canal. This may need treatment with antibiotic ear drops as well. If the infection is treated appropriately, such perforations will almost always heal.
Signs and symptoms
In babies and toddlers you should look for some of the following symptoms:
- Hearing problems
- Severe, stabbing pain in ear
- Crying, irritability and pulling of ear
- Fluid build-up behind the ear drum
- Fever (above 38* C)
- Dizziness and loss of balance
- Diarrhoea, nausea, vomiting.
Treatment
Regular paracetamol can help to relieve pain. Or try applying a well-wrapped hot water bottle under the affected ear to soothe the pain. If the earache persists, consult a doctor, who may prescribe antibiotics and medication. It is extremely important that the child takes the full prescribed dose of medication as directed by the doctor, so the infection does not recur.
A follow-up appointment is usually necessary to check that the infection has completely cleared. If the eardrum is perforated, more follow-up visits will usually be required.
Other causes
Young children often poke small objects into their own or other children's ears. Objects that are small enough to enter the ear, such as a pea, can be another dangerous source of infection.
The presence of small foreign objects should be easily suspected, as the child is likely to show signs of being in pain and discomfort. Or there may be a discharge from the ear.
Only attempt to remove the foreign object gently with a pair of tweezers if it is just at the entrance to the ear canal and can be easily grabbed. If this is not the case, take the child to a doctor or accident and emergency department. Avoid applying any kind of pressure to the ear, as this could cause damage.
Preventing ear infections
There are many steps that you can take to help reduce the frequency of ear infections in children. As a general guide:
- Ensure that both you and the child frequently wash your hands
- Encourage the child to cover their mouth when coughing or blowing their nose
- Use a tissue once and throw away after use
- Toys that are put in the mouth should not be shared with other children, and should be washed and disinfected after use
- Avoid exposing the child to smoky environments
- If possible, limit the child's contact with people who have colds
- If a child has perforated ear drums, avoid getting water in their ears when washing.
Remember
If the child's ear infection is left untreated for a long period of time it may result in permanent hearing loss. It is important to be vigilant and to ensure the symptoms are treated as soon as possible.
