Otitis Media
(Earache · Ear infection · Middle Ear Infection)
In this condition factsheet:
The Facts on Otitis Media
Otitis media is a middle ear infection that is most common in infants and young children under 4 years of age. By the age of one year, most children will have had one or more middle ear infections.
Although a middle ear infection can occur at any age, it's most common between the ages of 3 months and 3 years, and is much less common in older children and adults. Ear infections do not spread from person to person and they most commonly occur with a cold. Antibiotics are often used to treat ear infections, but in certain circumstances, a doctor may suggest waiting for 2 to 3 days before starting antibiotics.
Causes of Otitis Media
The middle ear is connected to the throat by a small tube called the eustachian tube. It's protected from the outside by a thin shield called the tympanic membrane, or eardrum. Viruses and bacteria that normally live in the throat can sometimes cross into the middle ear through the eustachian tube, causing an infection.
Winter is high season for ear infections. They often follow a cold. Some factors that increase a child's risk for middle ear infections include:
- crowded living conditions
- attending daycare
- exposure to second-hand smoke
- respiratory illnesses such as the common cold
- close contact with siblings who have colds
- having a cleft palate
- allergies that cause congestion on a chronic basis
- not being breast-fed
- bottle-feeding while lying down
Barometric trauma is another risk factor for a middle ear infection. The pressure in the middle ear rises when the airplane you are travelling on descends or when you ascend while scuba diving. If the eustachian tube is not open, the pressure in the middle ear cannot be equalized, and thus, may cause injury, which increases the risk of an acute ear infection.
Symptoms and Complications of Otitis Media
Middle ear infections can be categorized as acute, serous, or chronic.
Common symptoms of acute otitis media are fever, pain, and irritability. In children, the ear infection often begins after the child has had a cold for several days. You may notice your child tugging at their ears, though this does not always mean an ear infection is the cause. Young children may also tug at their ears when they're teething, for example.
It's more difficult to detect signs of ear infection in young babies. You may notice a change in mood or feeding, and the infant will most likely have a fever. Because ear infections are usually painful, many babies will be irritable and cry – particularly when lying down.
If fluid builds up in the ear, the infection is called serous otitis media. (That's serous, referring to fluid, not serious.)
This occurs when the eustachian tube becomes blocked, and pressure in the middle ear drops. Under these circumstances, the child might experience hearing loss or impairment in the infected ear. This is usually only temporary. While this is usually no cause for alarm, anyone who experiences hearing loss or impairment should consult their doctor.
Seek immediate medical attention if you notice a fever of 39 °C or higher, pus or discharge coming from the ear, worsening symptoms or symptoms that last for more than 2 to 3 days.
Chronic otitis media refers to a long-lasting ear infection. This is often complicated by (or caused by) a hole in the eardrum (perforation) from any one of the following:
- acute infection
- blocked eustachian tube
- injury from sudden air pressure changes
- injury from an object entering the ear
Chronic ear infections often flare up after a cold, or, if the eardrum is perforated, when water enters the ear during swimming or bathing. Repeated or long-lasting infections can destroy the small bones in the middle ear, leading to long-term hearing loss. More serious complications include spread to nearby organs, appearing as inflammation of the inner ear, facial paralysis, and brain infections.
