Ear Problems

In childhood, ear infection is a pretty frequent disease. A special problem are secretory otitis (otitis media with effusion, „silent“ otitis media) and recurrent acute ear infections, which most often occur as a result of unadequately treated infection of the ear and the respiratory tract. Every ear infection has to be  treated until the ear drum looks normal and a normal tympanometric finding is obtained. The ear drum, in children as well as in adults, has to be examined with an otoscope, not with an ordinary funnel.

Often ear infections are treated with a brief antibiotic or other therapy, after which no normal otoscopic and tympanometric finding are obtained!  It is extremely important that the physician is well trained to interpret otoscopic and tympanometric findings.

Disappearing of redness of the ear drum does not mean that the middle ear has healed; on the contrary, a characteristic of secretory otitis media (otitis media with effusion) is that the ear drum is NOT red, but has other features.

Secretory otitis media (so-called “silent” otitis media,  otitis media with effusion), often goes without pain, and therefore patients are often surprised when we inform them of the findings.  A child with this problem may hear less well, develop more slowly, not do well in school and look uninterested. Often parents do not understand that their child is hard of hearing, but think it is disobedient or deliberately ignores their call. It is no exception that these children are sent to a pedagogue or psychologist instead of an ENT specialist.

Today it is common knowledge that in secretory otitis media the secretion of the middle ear in 90% of the cases contains bacteria. This was proven by laser scan-microscopy, which in itself does not have a hundred percent sensitivity. At our disposal are conservative and surgical treatment. With the right therapy a great number of children recover without surgical treatment.

It is important to check the child’s condition regularly and treat each new infection properly, because over a certain period of time the child will be susceptible to ear infection.