The middle ear, which contains the hammer, anvil and stirrup ossicles, is normally filled with air and its pressure is the same as the external environment pressure. It opens into the nasal cavity through the structure we call the Eustachian tube. It has an important role in hearing and balance function with this ossicular structure that is connected to the inner ear. Fluid that accumulates with the decrease in middle ear pressure, middle ear infections and problems in the ossicular system can cause permanent hearing problems if not treated in time.
How does fluid accumulation in the ear occur?
The anatomical structure in children is due to its characteristics. Therefore, fluid accumulation in the middle ear and middle ear infections are more common than in adults. The middle ear opens to the nasal region via the eustachian tube. The function of this structure is to provide ventilation and drainage of the middle ear. The Eustachian tube is shorter and horizontal in children than in adults, and reaches its adult angle at the age of 7. Adenoids are a common problem in children. Enlarged adenoid can both cause blockage at the mouth of the Eustachian tube and serve as a reservoir for some microbes that play a role in middle ear infections. Some studies have shown that fluid accumulation is more common in children with allergies or weak immune systems. Middle ear problems are mostly seen in children between the ages of 2-5.
What complaints are seen in the child?
The most important symptom is hearing loss. It is important to make the diagnosis at an early stage, as there are no other symptoms such as pain or fever. The child's delay in responding to his/her parents' voices or difficulty in responding to them, starting to turn up the volume of the television too much, having to call the child loudly when calling, or having difficulty listening to teachers and friends at school, which may affect school success. Falling may be clues to hearing loss caused by fluid accumulation in the ear. Some children may be disturbed by occasional pain in the ear and the sounds they hear in the ear. & nbsp;
How is it diagnosed?
During the examination, a color change such as dulling of the eardrum, prominence in the vascular structure, redness may be observed, and sometimes collapses of the eardrum may be observed. Fluid accumulation and air bubbles may be seen behind the eardrum. In a patient with suspected fluid accumulation in the ear, middle ear pressure test and hearing test confirm the diagnosis.
How is it treated?
The treatment of fluid accumulation in the ear is primarily medication. Since studies have shown that inflammatory factors also affect fluid accumulation, antibiotics are used primarily in the treatment. The patient is treated with a 10-14 day course of antibiotics. In addition, sprays and syrups called decongestants, drugs called antihistamines for allergic patients, and cortisone sprays can be used as drugs to help absorb fluid. After this drug treatment, the patient is followed up. If there are no special conditions such as changes such as collapse of the eardrum or severe hearing loss, the patient can be followed with occasional checks for up to 3 months. If the problem in the middle ear persists at the end of this period, tube insertion is performed. If the tube insertion procedure is to be performed alone, it is performed under general anesthesia and in a short procedure, without any incision, by entering the external ear canal under the guidance of a microscope and making a small incision in the eardrum. After a few hours of bed rest after the procedure, the patient is sent home the same day. No medication is required after the procedure. In children, the procedure is often performed with accompanying tonsil and adenoid problems, and this does not affect the tube insertion process and afterwards.
With ear tube surgery, the fluid accumulated in the middle ear is eliminated, fluid accumulation and recurrence of otitis media are eliminated. The risk is significantly reduced. Hearing loss caused by fluid is corrected.
Ear tube and its insertion
How long does the ear tube stay in the ear?
Ear tubes placed in the eardrum stay in the ear. The duration varies depending on the type of tube and the characteristics of the child. The tubes chosen for a child who has an ear tube inserted into his ear for the first time are short-term tubes. These tubes remain in the ear for an average of 6-9 months and are then expelled by the body from the eardrum into the external auditory canal.
In ear tube applications in children resistant to repeated treatment, long-term tubes, which we call T-tubes, are used. Long-term ear tubes remain in the ear for more than 1 year, as prescribed by the doctor. Long-term tubes that cannot be easily eliminated by the body are usually removed by the doctor. The child with an ear tube does not feel it and does not experience any pain or discomfort. Since the inner diameter of the tube is very small, it is generally very difficult for liquid to enter from the outside. However, it is useful to be careful when taking a bath, sea, or swimming in the pool, but it does not affect the child's activities at all.
Read: 0
