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Dr. Andrew Rynne

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What is the cause of recurrent otitis media in an infant and how can it be treated permanently?

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Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2565 Questions

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Posted on Fri, 2 Nov 2018 in Ear, Nose and Throat Problems
Question: Hello,

I have a 8 1/2 months old daughter who has already had 11 otitis over the last 6 months. What kind of solutions are available to try to stop this from repeating? She's always been treated by antibiotics (Amoxiciline), which work, but generally one week after the end of the treatment, it starts again.
I live in France and it would be great if my question could be answered by a French doctor if possible.
Thank you in advance.
Best regards,
Jerome
doctor
Answered by Dr. Sumit Bhatti 16 hours later
Brief Answer:

Recurrent / Persistent/ Resistant Otitis Media.

Detailed Answer:

Hi,

Thank you for your query.

1. Otitis Media is one of the commonest childhood problems. There is no doubt that antibiotics are recommended for acute otitis media in children under 2 years of age.

The differentiation between recurrent, persistent and resistant otitis media is important. In resistant cases, longer duration of antibiotic therapy (up to 8 weeks) will be required.

2. It is important to get Impedance Audiograms (Tympanometry) done in between episodes and if there are signs of persistent middle ear fluid (effusion), a myringotomy with grommet (ventilation) tube insertion will reduce the frequency of the otitis media.

3. The eustachian tube which connects the ear to the back of the nose is wider, shorter and more horizontal as compared to adults.

Nasal secretions and milk can easily enter the middle ear. Hence it is important to keep her head higher (and not make her lie flat) while feeding.

Longer duration of breast feeding is known to boost immunity. Pneumococcal vaccination is recommended. A lateral X-ray of the skull to rule out adenoid hypertrophy is necessary.

4. Use of pacifiers, exposure to passive smoking, genetic and environmental factors (allergies, extreme cold) is also implicated in repeated episodes of otitis media.

5. If you are in XXXXX or XXXXX XX XXXXXX, I would recommend that you consult Dr. XXXXXXXXX XXXXXXX at CHRU (Centre Hospitalier RĂ©gional Universitaire) de Lille.

I hope that I have answered your query.

Regards,

Dr. Sumit Bhatti,
ENT Specialist
Above answer was peer-reviewed by : Dr. Nagamani Ng
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