MENTSA’s Beverly Fulcher, M.D. discusses why ear infections are so predominant with young children and how they can cause hearing loss.

Statistics show that five of six children will have at least one ear infection by their third birthday. Dr. Beverly Fulcher, an ENT specialist with MENTSA, located in Flowood, Mississippi provides valuable information on what causes this painful condition that can lead to hearing loss.

How do ear infections cause hearing loss?

There are three main components of the ear.  They are the external ear canal, middle ear and inner ear. You can have hearing loss related to a problem in any one of those areas.

The most common reason for hearing loss in the external ear canal is from cerumen impactions. We can easily clean the ear canal under  a microscope or by irrigating the ear.  Another reason for hearing loss from the ear canal is external otitis.  There are two types of external otitis.  One is bacterial, which we commonly see during the summertime in children.  Usually treatment requires antibiotic eardrops- but sometimes it requires cleaning out the ear canal under a microscope. The other type of external otitis is fungal. The ear canal will fill with white or gray debris and this does not respond to antibacterial drops. The treatment is to clean the ear canal under a microscope and place a topical antifungal medication into the ear canal.

The middle ear is another location that can cause hearing loss. Hearing loss in the middle ear can be due to problems with the eardrum (a thickened eardrum or a hole in the eardrum),  problems with the three  ear bones , or a middle ear infection that causes the middle ear space to be filled with mucous or pus  instead of air. The eardrum and ear bones cannot vibrate optimally in a mucous medium and the sound waves are not as easily transferred to the inner ear when the middle ear is filled with mucous.

The inner ear can also be a location of hearing loss. This is called sensorineural hearing loss. It can be due to a problem with the inner ear organ for hearing (called the cochlea) or the nerve that sends message to the brainstem (the vestibulocochlear nerve).  Sensorineural hearing loss can be due to noise exposure, increasing age, or family tendency to lose hearing.  Also, some medications and underlying illnesses or infections can cause this type of hearing loss. Sometimes people are born with sensorineural hearing loss.  All infants born Mississippi are screened shortly after birth to detect this condition early.

Why does a child’s eustachian tube make them more prone to middle ear infections than adults?

The middle ear is connected to the outside world through the eustachian tube, which comes out in the back of the nose.  In young children, the eustachian tube is positioned at a more horizontal angle and is shorter than in adults. That makes children more prone to ear infections- particularly when they have a viral upper respiratory tract infection or enlarged adenoids that block the drainage of the eustachian tube in the back of the nose.

When do children start to outgrow tendencies of middle ear infections?

Typically, the eustachian tubes start to mature when a child reaches two years old.  However, some individuals’ eustachian tubes never mature  enough to where they’re not prone to ear infections.  There are some adults that have multiple sets of ear tubes throughout their lives.

 

Does family history affect children’s likelihood to get middle ear infections?

There is a family tendency for ear infections.  Typically, children with ear infections have parents or siblings who have history of ear infections. This predilection is mostly because of hereditary problems with the eustachian tube or tendency to have enlarged adenoids.

How do upper tract respiratory infections lead to ear infections?

Children are also more prone to ear infections because they catch viral upper respiratory tract infections more frequently than adults.  This causes inflammation of the eustachian tube, which in turn causes mucous to get trapped in the middle ear space. The mucous has a high protein content, and so bacteria from the nose migrates to the middle ear space through the eustachian tube to feed on the protein in the mucous. This process leads to infection in the middle ear space.

Why are children more prone to ear infections once they turn six months old?

Two things happen at the age of six months.  The first is that children become mobile and want to put everything in their mouth, so they are exposed to more germs and get sick more frequently.  Also, 6 months old is about the age that the IgG antibodies, special immune system proteins that cross the placenta during development, begin to break down.

About MENTSA

MENTSA is one of the leading ear, nose and throat and audiology practices in Central Mississippi and specializes in effectively treating ear infections. The Mississippi Ear, Nose and Throat staff utilizes state-of-the-art equipment while providing personalized attention to each patient.  To schedule an appointment, please call us at 601-709-7700 or request an appointment time online at https://www.mentsa.com/patient-information/request-an-appointment/