Otitis Media (Middle ear infection)

Otitis media is an infection of the middle ear, which is the area behind the eardrum. It should not be confused with otitis externa, also known as an outer ear infection or swimmer's ear, as it is common in the summer and among swimmers.

While a middle ear infection can occur at any age, it is most common in children between the ages of 3 months and 3 years. Babies and young children are more likely to develop respiratory infections, promoting middle ear infections. Their Eustachian tubes, which are the canals that connect the middle ear to the throat, are immature and do not yet function properly. Because the Eustachian tubes have less of a slope, fluid does not drain as well as it should, making it easier for bacteria to develop and make its way to the middle ear.

Ear infections can occur at any time of the year, but since they often develop after a cold or the flu, there are many more cases in the winter. A cold or the flu can cause swelling of the mucous membranes of the nose and throat and diminish clearance of bacteria from the nose, increasing the amount of bacteria in the nose.

Children in daycare are more at risk.

Symptoms and diagnosis

Symptoms include pain in the infected ear, often accompanied by fever, and at times by nausea and diarrhea, especially in very young children. Many individuals also experience hearing loss. Symptoms in infants include irritability or difficulty sleeping. Sometimes, pressure in the eardrum can cause it to rupture, causing pus to drain from the ear. The perforation from a rupture usually heals quickly and without need for further treatment.

Diagnosis of a middle ear infection involves an examination of the ears using an otoscope (device used to look at the eardrum). When infected, the eardrum is red and swollen. There is also fluid and/or pus in the middle ear.

Treatment

Acetaminophen (e.g., Tylenol, Tempra) or ibuprofen (e.g., Motrin, Advil) can be used to relieve pain and fever. Antibiotics may also be prescribed by a doctor. While most children feel better after 2 or 3 days, the antibiotic treatment must be finished.

When ear infections are recurrent, the doctor may suggest a myringotomy. This involves the creation of a small opening in the eardrum to insert a tiny tube. The goal of this procedure is to increase fluid drainage and prevent fluid from accumulating in the middle ear, thereby reducing the frequency of ear infections.

Prevention

The following measures may help reduce the risk of developing otitis media:

  • Make your home smoke-free (tobacco and fireplace)
  • Eliminate or treat allergies
  • Make sure that your child gets their routine childhood vaccines and flu vaccine
  • Wash hands carefully and frequently, especially during cold and flu season
  • Routinely perform nasal irrigation with saline
  • Breastfeed
  • Infants should not sleep with a bottle
  • Avoid giving your child a pacifier after 6 months of age

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