Ear infection (Otitis Media): An interview with Dr. Choffor Nchinda (ENT)

This is an interview blog post with Dr. CHOFFOR NCHINDA Emmanuel (MD)an ENT (Ear, Nose and Throat)specialist at the Buea Regional Hospital (BRH). 

1. HILPharma: Hello Dr. Choffor and welcome to our ENT series. We are very glad to have you on board with us. Today we will be talking about Otitis media. What is Otitis media?

Dr. Choffor Nchinda: Thank you very much HILPharma, always my pleasure. In simple terms Otitis media is an infection of the internal part of the ear, called middle ear.

2. HILPharma: In your practice, on average how many patients do you see with Otitis media per day or per month?

Dr. Choffor Nchinda: About 4 in 10 of my consultations are cases of an ear infection (Otitis Media).

3. HILPharma: Wow. 4 in 10? That is quite too many persons. What causes it?

Dr. Choffor Nchinda: hahaha hold up there. The number is just an approximate number. We have not yet carried out such a study at Buea Regional Hospital (BRH).

As for what could make one have an ear infection. Otitis media is caused by germs, most commonly viruses, but sometimes also bacteria.

People who just had a common cold are more likely to have an ear infection. It is also more common in children (3 months to 3 years) than in adults.

4. HILPharma: What are the likely signs and symptoms?

Dr. Choffor Nchinda: Most common are ear pain, ear drainage (pus outflow), ear fullness and mild hearing loss

In children, you may notice a fever or they cry more than usual or have trouble sleeping.

5. HILPharma: how do you diagnose a person with Otitis media? i.e. what do you usually do like…ear exam, history etc…if any tests are needed? and approx cost in Cameroon (public and private)

Dr. Choffor Nchinda: I normally ask the patients a few questions to get a better picture of what I am dealing with. I will also do a physical examination including an ear exam using an otoscope, (an instrument used to look into the ear).

In some forms of Otitis media, it will require tympanometry (an examination to test the condition of the middle ear) which has an average cost of 15.000 XAF

6. HILPharma: How does one treat Otitis media?

Dr. Choffor Nchinda: Most often painkillers (in most cases simple paracetamol will do) and anti-fever medications will do as most clear away on their own.

Sometimes an oral antibiotic is prescribed if a bacterial infection is suspected, this will be determined by your doctor.

7. HILPharma: What are the possible complications if someone delays treatment or poorly treats Otitis media?

Dr. Choffor Nchinda: They are quite rare. Most occur in children. We have tearing of the ear drum, hearing loss, brain abscess, meningitis and temporal bone abscess, just to name a few.

8. HILPharma: So doctor how does one prevent Otitis media?

Dr. Choffor Nchinda: Prevention of a common cold by practising hygienic measures like regular washing of hands

Properly treat a common cold, especially in children (good nasal irrigation with normal saline for example).

9. HILPharma: In your practice, what are some of the myths you noticed from patients and what do you have to say about them?

Dr. Choffor Nchinda: Oh yeah, I got a couple.

• ‘Mayanga’ ( palm kernel extract) DOES NOT treat ear pain. It actually makes proper ear examination difficult and prevents local treatment such as ear drops from acting well.
• Gentamycin ear drops (and in many cases even eye drops!!!) is not an omnipotent treatment for ear pain, it is actually ototoxic (can destroy the ear and cause deafness) and dangerous in cases of ear drum perforation (rupture).

10. HILPharma: Any medication safety tips you would want to share?

Dr. Choffor Nchinda:

• Avoid ear drops without medical advice, can be dangerous to the ear.
• Avoid antibiotics without a medical prescription. Even for common causes like Otitis media and sore throat, most cases are caused by viruses, so an antibiotic will not work.
• Always tell your doctor of any other medication you are taking to avoid dangerous interactions.
• Avoid ear syringing (flushing) and local ototoxic (dangerous to the ear) medication if you have a perforated (ruptured) ear drum.

11. HILPharma: Thank you so much for your time doctor. Will like to know, how does one book an appointment for a consultation with you?

Dr. Choffor: Easy! Head to Buea Regional Hospital any day, ask to see an ENT and you will be given a precise program for ENT activities. These include consultations, office procedures, surgery, explorations (endoscopy).

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