The modern child’s specialist spends as much time learning to examine the ear as he does any other part of the body. This is be-cause the child may have the earache before he is able to describe it and in any suspicious fever or upset, or onset of irritability, the ear should always be investigated.
In children, earache is usually due to infection of the middle ear and formation of pus inside the drum. The infection reaches the ear in practically every case from the throat, by way of the Eustachian tube which connects the middle ear and the back of the throat. In those infectious diseases, such as measles and scarlet fever, where the throat is involved, the infection is particularly likely to occur.
The Eustachian tube in a child is straighter and more open than in an adult. In the adult also the Eustachian tube is lined with little hairs which wave towards the exterior, and the skin also provides an antiseptic secretion. For this reason middle ear infection is far commoner in children than in adults.
It is highly important to drain pus once it has formed in the middle ear because if left alone it may form adhesions and result in partial deafness or, which is even worse, extend into the mastoid cells behind the ear. After pus is released from the middle ear the opening closes up when drainage has become complete and the scar can hardly be seen except by experts. Deafness in properly treated cases practically never occurs.
Quite as important as treatment in these conditions, is prevention. Any sore throat or cold is suspect for this reason. The hygiene of the throat is, among other things, to keep the air which the child breathes cool and moist. The young child can be taught to gargle by pretending that gargling is a game and having gargling parties.
“It is a great safeguard,” says Florence Brown Sherbon (“The ChildIts Development and Care,” McGraw-Hill Book Company, New York) “for a child to grow up with the idea that it is fun to gargle, and also to know how to open his throat to inspection and how to gargle thoroughly and well.”
Remember the symptoms of middle ear infection in a child may not suggest the localization of the trouble at all. Digestive upsets, restlessness, throwing the head around, unexplained fever, and a peculiar intermittent cry which the child voicesshrill and piercingfollowed by intervals of complete quiet, should all arouse suspicion.