Otitis Media (OM) is characterized by an inflammation of the middle ear and is typically associated with an accumulation of fluid. This fluid may or may not be infected. Infection is usually a bacterial or viral infection secondary to a cold, sore throat, or other respiratory problem. When the fluid is not infected, it results in a condition called otitis media with effusion (OME). Another name for this condition is Serous otitis media. If the fluid in the middle ear becomes infected, then the condition is referred to as acute otitis media (AOM). In both cases, there is fluctuating loss in hearing, which returns to normal. Rarely can a permanent hearing loss occur (Roberts & Medley,).
Children between the ages of 6 and 13 months have the highest risk of developing OM. At least 50% of children have had at least one episode by 1 year of age. The incidence remains high throughout the preschool years. An estimated 35% of children between 1 and 3 years of age will have recurrent episodes of OM (American Speech-Language-Hearing Association [ASHA],). Young children run the highest risk of developing OM because their eustachian tubes are more horizontal, shorter, and wider than those in adults. When a child has a cold, allergy, or some type of upper respiratory infection, the eustachian tube can become blocked, preventing the fluid from draining out of the middle ear (ASHA,; Roberts & Medley,).
Boys seem to have OM more frequently than do girls (ASHA,). Native American, Eskimo, or Hispanic children have the highest prevalence rates for developing OM. Caucasian and then African American children have the next-highest incidence rates (Bluestone & Klein,). Children who are at risk for OM include those with craniofacial anomalies such as cleft palate and those with various syndromes (e.g., Down syndrome). There are other risk factors that include family history of OM, day care attendance, passive smoke exposure, poor hygiene, and low socioeconomic status (Roberts & Medley,).
Treatment usually consists of use of antibiotics. If the fluid does not diminish, persists for more than 3 months, and a hearing loss is associated, the physician may recommend a myringotomy (insertion of a pressure equalization tube in the affected ear). The tube allows for ventilation in the middle ear and aids in keeping the air pressure in the middle ear near equal to that of the environment. The tube normally stays in the ear for 6 to 12 months and is typically expelled spontaneously (NIDCD,).
Because of associated hearing loss, language and learning difficulties may result, especially in cases of recurrent OM. The ability to receive information via the auditory channel is compromised, causing the child to receive a partial or inconsistent auditory signal. This results in the child’s encoding information imprecisely and may put the child at a disadvantage for acquiring speech and language. Consequently, later academic achievement—specifically in the area of reading and related language-based areas—may be affected. Inattentiveness may result from an inconsistent auditory signal; this may manifest as distractibility and problems working independently (Roberts & Medley,).
Teachers and caregivers can provide an optimal listening environment for the child by using face-to-face interaction, seating the child near the person who is speaking, attaining the child’s attention before speaking, speaking clearly, and using natural intonation. The environment can be modified to reduce background noise (Roberts & Medley,).
Consultation or evaluation by an audiologist and speech-language pathologist should be sought to further define the scope of the effects of recurrent OM. In some cases, delays in articulation and language development are sufficient enough to warrant speech-language therapy services in the school setting. These services generally produce positive results.
Research linking recurrent OM to later developmental difficulties is controversial. Further research is needed to clarify this relationship. Until then, medical management combined with collaboration with other allied health care professionals, caregivers, and teachers can minimize the effects of OM (Roberts & Medley,).
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(sēr′ŭs ō-tī′tis) Inflammation of middle ear mucosa, often accompanied by accumulation of fluid, secondary to auditory tube obstruction. syn ...