Why Children Ease Ear Ease?

Medical Video: Ears 101 : How to Relieve an Ear Ache
Most acute otitis media (congek) occurs in infants and children
Get to know the structure of the eustachian tube in our body
Why are children susceptible to this earache?
1. Size eustachian tube different
2. Form eustachian tube different
3. Tuba eustachius imperfect
4. Different adenoid sizes
5. The child's body defense system is still low

Medical Video: Ears 101 : How to Relieve an Ear Ache

One symptom of the ear that patients often complain about is the discharge of fluid from the ear canal or commonly called congek. Congestion is caused by inflammation of the middle ear, where there is accumulation of fluid in it. This condition is called Acute Otitis Media (OMA).

Most acute otitis media (congek) occurs in infants and children

A study that examines the age factor in the occurrence of OMA states that OMA is a disease that commonly occurs in infants, toddlers, and children. OMA cases in adults are also reported to occur, but with a number of cases that are not as high as in children. A study in Brazil mentions the estimated incidence of OMA in adults is only around 0.004%, although generally the severity is more severe in adults than in children.

In the United States, otitis media is the most commonly diagnosed in pre-school children, even the incidence has increased over the past decade. As many as 70% of children experience ≥ 1 OMA attack before the age of 2 years. In Canada, a study conducted in Quebec found that at the age of 3 years, 60-70% of children have experienced at least 1 episode of OMA. In Indonesia and developing countries, almost 65% of pre-school age children have had inflammation of the middle ear at least 1x, and this is increased in the middle to lower economic groups that have a low level of hygiene.

Seeing this fact, the question arises, why do children get earache easier? Apparently, the answer lies in the development of our bodies. Let's follow the explanation.

Get to know the structure of the eustachian tube in our body

Tuba eustachius is a channel that connects the middle ear cavity with the nasopharynx, the area behind the nose. Tuba eustachius usually in a sterile state and closed, and only open when air is needed to enter the middle ear or when chewing, swallowing, and evaporating. Tubal opening occurs when there is a difference in middle ear pressure and outside air pressure between 20 to 40 mmHg. Tuba eustachius has three important functions, namely:

Ventilation, is useful to keep the air pressure in the middle ear always the same as outside air pressure.
Protection, which protects the middle ear from sound pressure, and blocks the entry of fluid from the nasopharynx to the middle ear.
Drainage aims to drain the results of the middle ear fluid to the nasopharynx

Acute otitis media is closely related to function eustachian tube. Abnormal function eustachian tube is an important factor in otitis media. Most OMA in children begins with upper respiratory tract infections (ARI) or allergies, resulting in swelling of the upper airway wall, including tube eustachius. Tuba eustachius become narrow, resulting in negative pressure blockage in the middle ear. If this condition lasts long, it will cause the entry of a virus or bacteria from the nasopharynx into the middle ear through tube eustachius.

Then, if there is a disruption due to tubal obstruction, this will activate a complex inflammatory process that causes fluid to form in the middle ear. The presence of bacteria that enters the middle ear causes inflammation to become more intense and pus (congek). Hearing can be disrupted because the eardrum and bones of the hearing cannot move freely to vibration. Too much fluid can eventually tear the eardrum due to elevated pressure.

Why are children susceptible to this earache?

At the beginning of the development of the human body, the forms and functions of various types of organs are not fully mature in the neonatal, infant, and child years. Therefore, there are diseases that are easily suffered by children, as well as there are some diseases that are more common among adults. In Acute Otitis Media (OMA), there are several factors that cause children to be more susceptible to OMA, namely:

1. Size eustachian tube different

Size eustachian tube in children and babies shorter than adults. Tubal length of adults is 37.5 mm and in children under 9 months is 17.5 mm. This increases the chance of a connection from the back of the nose (nasopharynx) which will disrupt drainage through eustachian tube.

2. Form eustachian tube different

Form eustachian tube in infants and children is unique. The shape is wider and its position is more horizontal (flat) than the adult tube. This condition causes inflammation in tube eustachius become very common in children. The inflammation will trigger a disturbance in eustachian tube in protecting the middle ear so that the tendency for infection in the middle ear to increase.

3. Tuba eustachius imperfect

In children, eustachian tube not yet fully developed. Tubal diameter in children is smaller, causing blockages in the tube to occur more easily. Along with the development of age, tube eustachius will grow longer and narrower and will be more centered, far from the back of the nose. The result, function eustachian tube will be more established in protecting the middle ear. Therefore, in general the incidence of OMA will decrease with increasing human age.

4. Different adenoid sizes

Adenoids are one of the organs in the upper throat that play a role in the body's immunity. In children, adenoids are relatively larger than adults. Adenoid position adjacent to estuary eustachian tube so that large adenoids can interfere with opening eustachian tube.

5. The child's body defense system is still low

Undeveloped immunity in the body of babies and children causes them to be susceptible to various diseases One of the most common is acute respiratory infection (ARI). Recurrent ARI in children causes infection to spread to the middle ear. In addition, adenoids can become infected due to ARI and then spread to the middle ear through tube eustachius. The low level of IgA and IgG in children increases the tendency for OMA to occur in children compared to older people. Different things happen to adults, where the development of the immune system has developed stronger so that the attack of microorganisms can be anticipated better.