Patient's question:
Tianbao has yellow earwax in both ears (it was already hardened when discovered). One ear has more, and the other has less. Recently, I've noticed that the baby seems to have some hearing loss. A few days ago, I gave the baby a bath, but I don't know if water got into the ears. Another situation is that after the baby was one month old, the baby had a respiratory infection once, and since then, the baby's temperature has been fluctuating between 37.1 and 37.5. In the past three days, I've noticed that the baby's hearing has declined, and today I saw yellow stuff in the baby's ears.Doctor's answer:
Middle ear is an inflammation of the middle ear and is a common cause of ear pain in children. Middle ear is more common in children under the age of 8. It is often caused by pain complications from upper respiratory infections such as the common cold or throat infections. Ear pain is the main symptom of middle ear. However, young infants often cannot describe the location of the pain, so the only initial symptoms are fever and vomiting. Due to the short, wide, and straight Eustachian tubes in children, combined with their weaker immune systems, they are prone to acute rhinitis, tonsillitis, and other upper respiratory infections. Certain infectious diseases such as measles, scarlet fever, and influenza often cause increased secretions in the nasal pharynx. Additionally, when an infant spits up milk, coughs violently, or blows their nose too forcefully, bacteria can easily enter the middle ear through the Eustachian tube, becoming the most common factor or cause of purulent middle ear. Furthermore, if a child's ear is cleaned improperly, accidentally damaging the outer ear canal lining or eardrum, leading to infection, it may spread to the middle ear and cause inflammation.When there is no pus discharge from the middle ear, older children can describe their symptoms, but infants generally only become fussy and cry. Parents often feel helpless. However, if the ear is gently pressed with a finger, and the child cries more or defends themselves with their hand, it indicates an issue inside the ear. Additionally, due to gravity, when a child is held upright, the congestion in the ear improves, and pain often lessens, which also suggests the presence of middle ear inflammation. Other symptoms of middle ear include: children waking up at night in pain, pulling or rubbing one ear, partial hearing loss, and discharge from the ear (at this point, pain may often decrease, but it also indicates a ruptured eardrum).
Medical Advice: If the above symptoms appear, parents should take their child to the hospital for examination. The doctor will use an otoscope to check the child's ear. If there is any discharge, it can be collected to identify the microorganism causing the symptoms. The doctor may prescribe a course of antibiotics. Sometimes, the liquid discharge may remain in the ear for up to 3 months, so the child may still experience partial hearing loss. The eardrum typically heals within about a week. Three months after the child develops middle ear, the doctor may recheck their hearing to confirm if it has returned to normal. If the hearing is still impaired, the cause may be otitis media with effusion.
For acute purulent middle ear, in addition to rest, increased fluid intake, a nutritious diet, and ensuring regular bowel and bladder function, active anti-infection treatment should be given under the guidance of a doctor, along with local anti-inflammatory treatment for the middle ear. It is also important to remove the causative factors to maintain the patency of the Eustachian tube. If treated promptly and properly, the discharge will gradually decrease until healing occurs, and the perforated eardrum may also heal without affecting hearing. If treatment is delayed or improper during the acute phase, it may develop into chronic middle ear, leading not only to hearing loss but also to severe complications.
After treatment, the Eustachian tube will gradually widen as the child grows, making it easier for fluid to drain. As a result, the middle ear becomes less prone to infection. After the age of 7 or 8, it is less likely for children to develop middle ear again.