Otitis Media Paper Example

Introduction

Otitis media is an inflammatory and infective condition that affects the middle ear. This disorder is prevalent among children and significantly causes morbidity. This disorder is one of the leading causes of visits to healthcare facilities. This disease is a menace since it results in greater discomfort to its victims and even a permanent damage to the ear. In this regard, it is worthy to have an in-depth understanding of this disease for improved well-being of victims. This paper seeks to describe etiology, clinical manifestations, epidemiology, diagnosis guidelines, and treatment of otitis media.

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Etiology of Otitis Media

The causes of otitis media relate to pathophysiology that includes interaction between a host immune response and microbial agents, and middle ear cleft cell biology and nasopharynx. According to Qureishi et al. (2014), viral infections of the upper respiratory tract such as adenovirus, syncytial virus, and cytomegalovirus are essential causative agents that promote the progression of otitis media. They do so by creating a favorable environment that facilitates bacterial colonization, invasion, and adhesion to middle ear cells. It is prudent to note that bacteria are also regarded among the leading causes of middle ear effusion. Pumarola et al. (2013) explain that bacteria such as Haemophilus influenzae and Streptococcus pnuemoniae use eustachian tube as a passage to enter into the cleft of the middle ear. It is worthy to understand that infections in the upper breathing tract cause mucosal congestion in nasopharynx and the eustachian tube, thereby altering pressure regulation and normal function of the eustachian tube. If the congestion persists, it can lead to nasopharyngeal pathogen aspiration, which then inflammation as well as the collection of pus within the middle ear. It is important to highlight that inflammation of the middle ear makes it ossicles to be less mobile, a condition that may cause permanent hearing loss.

Clinical Manifestations

The most common symptoms of otitis media include fever and ear pain. Other symptoms include vertigo, loss of appetite, ear inflammation, and ear ringing. Also, other clinical manifestations include nausea, headache, crying among babies, and nasal congestion. Less common manifestations, however, include hearing loss and drainage of ear fluid (Schilder, Darrow, & Rosenfeld, 2013).

Epidemiology of Otitis Media

Otitis media is prevalent among children between six months and one year because of an anatomical predisposition. Young children have shorter, horizontal, and more flexible Eustachian tubes which allow easier entry of nasopharyngeal pathogens into the middle ear. It is vital to note that certain populations have higher prevalence rates of otitis media. Studies reveal that children from Greenland and Australian aboriginals are at higher risk of developing otitis media (Qureishi et al., 2014). The disorder is also common among children who have had prenatal or postnatal cigarette smoke exposure. A study by Monasta et al. (2012) elucidate that more than 709 million cases of otitis media are reported annually with children below five years old accounting for more than half the total number of cases. In particular, the prevalence of otitis media has declined in the US over the past two decades due to pneumococcal conjugate vaccine.

Diagnosis Guidelines and Treatment

Diagnosis of otitis media entails application of various clinical guidelines. The most preferred diagnosis method is myringotomy, a surgical eardrum incision. However, Qureishi et al. (2014) pinpoint that this method is not practical since it is imprudent to subject all kids to eardrum incision procedure. Another way to perform diagnosis is through examining the ears of children who have middle to severe tympanic membrane bulging. Moreover, clinical guidelines explain that children with mild tympanic membrane building with erythema or otalgia need to be assessed for otitis media. It is imperative also to use tympanometry and pneumatic otoscopy to assess eardrum mobility. Notably, an immobile eardrum that is non-perforated is an indication of middle ear effusion presence.

The treatment of otitis media entails a variety of surgical and medical recommendations. Medical treatment involves administration of antibiotics to children above six months old in cases where bilateral or unilateral acute otitis media is severe. Antibiotics are also prescribed for children between six and 23 months old who have non-severe bilateral otitis media. The commonest antibiotic used for the treatment of this disorder is amoxicillin. However, antibiotics that contain beta-lactamase should be used in instances where patients with otitis media do not respond to amoxicillin. Other than antibiotics, treating acute otitis media also entails pain management and assessment. It is vital to note that for surgical treatment, the practice entails insertion of ventilation tubes in case random acute otitis media results in persistent effusion of the middle ear (Qureishi et al., 2014).

Conclusion

Otitis media is threatening the lives of young children and adults as well. Its etiology is complex and multifactorial that involves viral and bacterial infection of the upper respiratory tract, and eustachian tube mucosal congestion, among others. Many people are being diagnosed with otitis media annually, a condition that calls for more research to avert its prevalence. Currently, there are medical and surgical treatments for otitis media. However, more research needs to be done to develop more effective ways of treating and eliminating this disorder.

References

Monasta, L., Ronfani, L., Marchetti, F., Montico, M., Brumatti, L. V., Bavcar, A., ... & Tamburlini, G. (2012). Burden of disease caused by otitis media: systematic review and global estimates. PloS one, 7(4), e36226.

Pumarola, F., Mares, J., Losada, I., Minguella, I., Moraga, F., Tarrago, D., ... & Cenoz, S. (2013). Microbiology of bacteria causing recurrent acute otitis media (AOM) and AOM treatment failure in young children in Spain: shifting pathogens in the post-pneumococcal conjugate vaccination era. International journal of pediatric otorhinolaryngology, 77(8), 1231-1236.

Qureishi, A., Lee, Y., Belfield, K., Birchall, J. P., & Daniel, M. (2014). Update on otitis media-prevention and treatment. Infection and drug resistance, 7, 15.

Schilder, A. G., Darrow, D. H., & Rosenfeld, R. M. (2013). Antibiotics for otitis media with effusion in children. Otolaryngology-Head and Neck Surgery, 148(6), 902-905.