A Complete Guide to Treating Otitis Media (Hong Kong Edition)

Otitis media refers to inflammation of the middle ear cavity, located behind the eardrum . It can be caused by bacteria, viruses, or other factors. The middle ear transmits sound from the outer ear to the inner ear. If it becomes inflamed or fluid accumulates, it can affect hearing. In severe cases, it can spread to the inner ear and even into the brain, leading to more serious complications.

In Hong Kong, otitis media can occur year-round, with children being particularly vulnerable because their Eustachian tubes are shorter and more horizontal, making it easier for pathogens to enter the middle ear. Furthermore, the peak cold season (autumn and winter) is also a peak time for otitis media.

The editor has integrated information from the Hong Kong Hospital Authority, the Department of Health and international otolaryngology departments to list in detail the types of otitis media, treatment methods and local medical information.

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1. Main types of otitis media

1. Acute Otitis Media (AOM)

   • Common after a cold
   • Symptoms: Earache, fever, hearing loss, ear fullness
   • In severe cases, the eardrum may be perforated and pus may flow out.

2. Otitis media with effusion (OME)

   • Middle ear effusion but not necessarily acute infection
   • Common in children, may cause hearing loss and affect learning

3. Chronic Suppurative Otitis Media (CSOM)

   • Long-term perforation of the eardrum and recurrent pus discharge
   • It may be related to cholesteatoma, so be careful

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2. Causes and Risk Factors

• Upper respiratory tract infections (colds, sinusitis)
• Eustachian tube dysfunction (more common in children)
• Allergic rhinitis
• Secondhand smoke exposure
• Water in the ears caused by swimming or diving
• weakened immune system

💡Editor ’s Tip :
Hong Kong schoolchildren are more likely to develop otitis media during the peak flu season in winter. Parents should pay attention to their children's ear pain, hearing loss or fever.

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3. Treatment Principles

The goals of treatment are to control infection, alleviate symptoms, and prevent complications . Treatment varies depending on the type and severity of otitis media.

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1. Acute otitis media

• Mild cases (uncomplicated)
  • Observe for 2-3 days. Some viral or mild bacterial infections can heal on their own.
  • Pain relievers (such as acetaminophen, ibuprofen)
• Bacterial or severe symptoms
  • Antibiotics (usually amoxicillin or amoxicillin-clavulanate)
  • Both public and private clinics in Hong Kong can prescribe medicine
• Perforated eardrum or pus discharge
  • Requires ear cleaning
  • Possibly antibiotic ear drops

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2. Otitis media with effusion

• Antibiotics are generally not used
• Observe for 3 months, during which hearing is monitored
• Allergic rhinitis or nasal congestion should be treated at the same time
• Persistent fluid accumulation or hearing loss → Consider ear tube placement (Grommet)

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3. Chronic suppurative otitis media

• Regular ear cleaning (performed by an otolaryngologist)
• antibiotic ear drops
• If cholesteatoma is present or recurrences occur frequently → Ear surgery (tympanoplasty)

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4. Surgical treatment

Both public and private hospitals in Hong Kong provide:

• Tympanoplasty : Repair of a perforated eardrum
• Tympanomastoidectomy : Treatment for cholesteatoma or chronic infection
• Grommet Insertion : Draining middle ear fluid and improving hearing

💡Cost reference (single ear surgery) :

• Public hospitals: approximately HK$100-$500 (waiting required)
• Private hospital: approximately HK$20,000-HK$50,000 (depending on the type of surgery and doctor's fees)

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5. Access to Medical Treatment in Hong Kong

• Public hospital emergency room : suitable for acute severe pain, fever, ear discharge, dizziness, facial paralysis and other emergencies
• Public ENT specialist clinics : require referral from a family doctor or general practitioner, and have long waiting times
• Private ENT clinics : Short waiting times, consultation fees including medication are around HK$500-HK$1,200
• General Clinic : Can treat minor illnesses, prescribe medication, and refer to specialists when necessary

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6. Daily care and prevention

• Avoid swimming if you have a cold or nasal congestion
• Teach children not to blow their nose too hard
• Keep your ear canal dry
• Quit smoking and avoid secondhand smoke
• Check children's hearing regularly, especially those with a history of recurrent otitis media

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7. When is it necessary to seek medical attention immediately?

• Persistent high fever
• Severe ear pain that suddenly stops (possibly a perforated eardrum)
• Pus or bleeding from the ear
• Sudden hearing loss, tinnitus, and dizziness
• Weakness on one side of the face (possibly facial nerve involvement)
• Severe headache and neck stiffness (to rule out intracranial infection)

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💬Let me tell you :
Otitis media isn't just for children; adults, especially those with nasal allergies and those who frequently dive or swim, are also at risk. Many parents in Hong Kong worry about the side effects of antibiotics. However, for confirmed cases of acute bacterial otitis media, appropriate antibiotic use can effectively prevent hearing loss and intracranial complications. Furthermore, while otitis media with effusion is painless, it can significantly impact a child's language development, so parents should be vigilant.

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⚠️ Disclaimer <br>This article is for reference only and does not constitute any medical advice. It is sourced from major medical articles.