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Otitis Media
ICD 382.9

Article by:
Sarah Morales, BS
Children's Speech Care Center

Otitis media is the medical term for a middle ear infection. This illness is common in children: 33% of children experience at least one infection by the age of 3, 66% experience at least one by the age of 6, and by the age of 9, nearly all children have had at least one. Ear infections usually begin with allergies, a cold, or flu, which cause nasal congestion. This congestion affects the eustachian tubes, which connect the inner nasal cavities with the middle ear for ventilation of the middle ear. When these tubes become congested, they seal pressure within the middle ear. This negative (inward towards the body) pressure combined with the presence of excess mucous creates an environment where bacteria can grow. Allergies are a more common cause of ear infections on the West coast of the United States, whereas colds/flu are the most common causes of ear infections on the East coast.

If a speech-language pathologist suspects otitis media, he/she makes a referral to a physician, who evaluates the child and prescribes medication. Symptoms often include fever and ear pain; a toddler or infant who cannot complain of ear pain verbally may cry or tug at his/her ears. Physicians may say that an ear infection is cured when the course of antibiotics is finished. However, audiologists (hearing specialists) have determined that middle ear fluid (now minus bacteria) remains present 12-14 weeks following antibiotic treatment. The presence of this fluid impairs hearing (called a transient hearing loss—meaning a non-permanent loss). The frequent occurrence of otitis media can affect the development of speech and language. For a child with repeated bouts of otitis media, an ENT (ear-nose-throat) surgeon may place PE TUBES (pressure-equalization tubes) in the child’s middle ear to ventilate the ear and prevent otitis media’s recurrence.

Audiologists have determined that children need to hear speech at a louder level than adults do to understand it. Thus, even a very mild hearing loss affects children’s understanding of speech. For a toddler or infant learning speech and language, such a hearing loss has even greater effects, making this learning impossible or nearly so. Thus, many children with frequent bouts of otitis media may have speech and language impairments such as developmental articulation delays/ disorders or developmental language delays/disorders (see sections on these disorders).

If otitis media remains untreated, permanent hearing loss or brain damage could result. A team of professionals are often involved in the evaluation and treatment of otitis media, including physicians, ENT doctors, audiologists, and speech-language pathologists. The first priority, overall, is to identify and treat the infection with medication, as prescribed by the physician.

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