Otitis Media (Middle Ear Infection) Otitis media is inflammation located in the middle ear, which may cause the space behind the eardrum (the middle ear) to become filled with infected fluid. The eardrum usually appears red and swollen. A cold, sore throat, or respiratory infection can cause otitis media. Middle ear fluid (also known as effusion) and otitis media can occur in the same child at different times. When ear infections are effectively treated with antibiotics, the pus changes into a different form of fluid. Although this fluid may not cause pain, it may cause a mild sensation of ear fullness or discomfort. This fluid is harmful because its continued presence predisposes toward an ear infection. The fluid temporarily reduces and distorts hearing. If they are not diagnosed or treated, ear infections or fluid in the ear may result in a hearing disability and in speech and learning delays/difficulties for the child Here are some interesting facts about otitis media: about 75 percent of children have at least one episode by the time they are three years old. nearly half of these children have three or more episodes by the time they are three years old. although it mainly affects children, otitis media can also occur in adults. otitis media is the most commonly diagnosed disorder in children in the United States. about 30 million pediatrician visits each year are a result of otitis media. otitis media occurs most often in children younger than seven years of age, and even more frequently in children between the ages of six months and three years. otitis media occurs more often in the winter and early spring. Who is at risk for getting ear infections? Your child’s risk of developing ear infections may increase from the following: being around someone who smokes a family history of ear infections a poor immune system spending time in a child care setting absence of breastfeeding having a cold being bottlefed while lying on the back What causes otitis media? Middle ear infections usually occur because of poor function of the eustachian tube, the canal that links the middle ear with the throat area. The eustachian tube helps to equalize the pressure between the air around you and the middle ear. When this tube is not working properly, it prevents normal drainage of fluid from the middle ear, causing fluid to build up behind the eardrum. When this fluid cannot drain, bacteria and viruses in the ear can grow and lead to acute otitis media. Why doesn’t the eustachian tube work properly in some children? Here are some common reasons: a cold or allergy, which can lead to swelling and congestion of the lining of the nose, throat, and eustachian tube immature anatomy of the eustachian tube enlarged adenoids in children small lumen of eustachian tube in children What are the different types of otitis media? There are several types of otitis media, including: acute otitis media (AOM): The middle ear infection occurs abruptly, causing swelling, ear pain, and temporary hearing loss. otitis media with effusion (OME): Fluid (effusion) remains in the middle ear after an initial infection subsides. A feeling of fullness in the ear and temporary hearing loss may be noted. What are the symptoms of otitis media? Although each child may experience symptoms differently, here are the most common ones: unusual irritability difficulty sleeping or staying asleep tugging or pulling at one or both ears fever fluid draining from ear(s) loss of balance hearing difficulties ear pain nausea and vomiting diarrhea decreased appetite congestion You should always consult your physician if you suspect your child has otitis media because these symptoms may resemble other medical conditions or problems. How do you diagnose otitis media? We start with a complete medical history and physical examination. Using an otoscope, we inspect the outer ear(s) and eardrum(s). We may use an otoscope, which is a lighted instrument that allows us to see inside the ear. A pneumatic otoscope blows a puff of air into the ear to test eardrum movement. Another test we might use is tympanometry, which can determine how the middle ear is functioning. Tympanometry does not tell whether the child is hearing or not, but helps to detect changes in pressure in the middle ear. If tympanometry is performed, the child must remain still and not cry, talk, or move. (This can be difficult!) If a child has frequent ear infections, we may suggest that a hearing test be performed. How do you treat otitis media? Specific treatment will be determined by your child’s physician based on the following: your child's age, overall health, and medical history extent of the condition your child's tolerance for specific medications, procedures, or therapies expectations for the course of the condition your opinion or preference Treatment may include antibiotic medications by mouth or ear drops or medication for pain. If fluid remains in the ear(s) for longer than three months, or if your child continues to have frequent ear infections, your child's physician may suggest that small tubes be placed in the ear(s). This surgical procedure, called myringotomy (see below), is usually used as a last resort after medical treatment has not helped or that the risks of medical treatment (such as reactions to antibiotics) are too high. What happens if otitis media is not treated? Any/all of the following can occur: infection in other parts of the head permanent hearing loss (rarely) problems with speech and language development
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