What is Otitis Media?

QUESTION: I know there can be many forms of infections to the ears. My
youngster was recently found to have a form called "Otitis Media". What is
otitis media and how did he get it?
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ANSWER: Otitis media is any inflammation of the middle ear. Bacterial
infection of the upper respiratory tract is the most common cause of otitis
media, which is frequently associated with obstruction of the eustachian tube
(the canal between the middle ear and the area above the soft palate). The
eustachian tube is responsible for maintaining proper pressure in the middle
ear, and obstruction of the tube can result in negative middle ear pressure
and/or effusion (escape of fluid).
With the discovery that frequent reexposure to an allergen can cause
inflammation that leads to eustachian tube obstruction for extended periods of
time, allergic rhinitis has been implicated in otitis media as well. The role
of viruses is unclear because they are extremely difficult to culture.
The condition occurs most frequently in children aged one to four years.
The incidence decreases gradually through ages six and seven, and it drops
abruptly after age ten. However, it can occur at any age.
In cases where the otitis media is accompanied by fluid forming in the
middle ear, antihistamine-decongestant therapy may be effective, but results
of various studies about this yield differing results. Because bacteria are
found in most cases, antibiotics are the mainstay of therapy. In those
patients who don't respond readily to antihistamine-decongestant therapy or
antibiotics, other treatment options include corticosteroids, cromolyn, or the
insertion of a tympanostomy tube (a small tube inserted through the membrane
that separates the middle ear from the outer ear canal) to permit drainage of
the middle ear.