MEDICAL SURFARI: A PAIN IN THE ERE AND THE POCKETBOOK

For those of you with an adventurous spirit, $1,300 and a little bit of shopping around, can buy you a roundtrip ticket from St. Louis to just about any major city in the world. If you are more sedentary and prefer virtual travel, that amount of money will buy you a new computer and Internet access.

Or, for working parents of preschool children, $1,300 is the combined indirect and direct cost (parental time lost from actual or imputed work plus medical costs) of three months of treating the most common of all childhood medical disorders: acute otitis media, or middle ear infection.

This finding is the result of research done by six medical researchers from Washington State and recently presented at a national pediatric ear, nose and throat meeting.

Acute otitis media (AOM) is an inflammation in the middle ear, the area behind the eardrum, and it is usually associated with a buildup of fluid that may or may not be infected. When infection is present puss builds up inside the middle ear causing pain, pressure and inflammation. The eardrum becomes inflamed and red, causing severe pain and temporary hearing loss. The middle ear contains three tiny bones that carry sound vibrations from the eardrum to the inner ear, to relay the sound vibrations to the brain.

When fluid is present the vibrations are not transmitted efficiently and sound energy is lost, resulting in mild or moderate hearing loss. This type of hearing loss is usually temporary, however, when AOM occurs over and over, damage to these structures may occur resulting in permanent hearing loss.

Children learn speech and language by listening to others talk and this is especially critical during early speech development in the first few years of life. Children with hearing loss do not get the full benefit of language learning experiences and critical delays in speech and language development may occur.

How can you tell if your child has AOM? They are usually fussy and irritable and may have trouble sleeping, feeding or hearing. AOM may occur with or without pain or fever. Your child may show inattentiveness or may turn up the volume on the television or radio louder than usual, may misunderstand directions, show listlessness or pull or scratch at the ear(s).

Fortunately, with early identification serious medical complications can be avoided. Most cases of AOM can be treated medically, although in some cases surgical treatment is necessary. If antibiotics are prescribed be certain that the child takes the full course of the antibiotics even if symptoms have resolved before the prescription runs out. This will reduce the chance of re-infection with bacteria that will be more difficult to treat.

Scientific evidence has shown that some environmental factors can increase the risk for AOM. Children who are bottle-fed rather than breast-fed, children exposed to passive tobacco smoke and children who attend group child care facilities appear to be at higher risk for developing AOM. Two out of three children have at least one episode of AOM by their third birthday. In fact, AOM ranks second to the common cold as the most common health problem in preschool children. For schoolchildren, an estimated five million school days are missed every year due to AOM.

Symptoms of AOM may improve spontaneously within 48 hours; however; many require a 10-day course of antibiotics for complete resolution of the infection. Once the infection has resolved about 40 percent of children still have some noninfectious fluid in the middle ear that dissipates within two to eight weeks.

If your child develops symptoms of AOM do not put anything in the ear other than drops prescribed by your doctor. Heat applied to the ear using a heating pad or hot water bottle wrapped in a towel may help relieve the pain and non-aspirin medications can be given to help reduce fever and pain. Rest is recommended until fever and pain subside. Be certain to take your child to your family doctor or pediatrician for proper evaluation and treatment and avoidance of the serious complications of AOM.