A middle ear infection or inflammation of the middle ear happens when a virus or bacteria inflames the area behind the eardrum. This is also known as otitis media and is most common in children.
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Most middle ear inflammations occur during the winter and early spring. Middle ear inflammations usually go away without any medication. However, you should seek medical treatment if pain persists or you have a fever.
Acute otitis media
This type of ear infection comes on quickly and is accompanied by swelling and redness in the ear behind and around the eardrum. Fever, ear pain, and hearing impairment often occur as a result of trapped purulent fluid or mucous behind the eardrum.
Otitis media with effusion (OME)
After an infection goes away, mucous and fluid will sometimes continue to build up in the middle ear. This may also occur as a result of a cold or other conditions, like cleft palate. This can cause the feeling of the ear being full and affect your ability to hear clearly.
There are several reasons children get middle ear inflammations. They often stem from a prior infection of the respiratory tract that spreads to the ears.
When the tube that connects the middle ear to the pharynx (eustachian tube) is blocked, fluid will collect behind the eardrum. Bacteria will often grow in the fluid, causing pain and inflammation.
There are a variety of symptoms associated with middle ear inflammations. Some of the most common include:
A doctor will make sure they have your child’s medical history and perform a physical examination. During the exam, the doctor will look at the outer ear and eardrum using an instrument called an otoscope to check for redness, swelling, pus, and fluid.
Adults are usually much better at describing their symptoms in words than kids. Complications are the same for both adults and children, as is treatment.
The doctor might also conduct a test called tympanometry to determine whether the middle ear is working properly and if OME is present.
For this test, a device is put inside your ear canal, changing the pressure and making the eardrum vibrate. The test measures changes in vibration and records them on a graph. This will show the presence of fluid but not whether the fluid is infected. A doctor will interpret the results.
There are a number of ways to treat otitis media. Acute otitis media may be treated with antibiotics, but OME is not typically accompanied by infection, so antibiotics are not helpful or necessary.
A doctor will base treatment on your child’s age, health, and medical history. Doctors will also consider the following:
- the severity of the inflammation or infection
- the ability of your child to tolerate antibiotics
Depending on the severity of the infection, a doctor may tell you that the best option is to treat the pain and wait to see if symptoms go away. Ibuprofen or another fever and pain reducer is a common treatment.
Symptoms lasting more than 3 days usually mean a doctor will recommend antibiotics. However, antibiotics will not cure an infection if it’s caused by a virus.
Complications resulting from otitis media are rare but can occur. These complications include:
There are ways to lower your child’s risk of getting ear inflammations:
- Wash your hands and your child’s hands frequently.
- If you bottle-feed, always hold your baby’s bottle yourself and feed them while they’re sitting upright or semi-upright. Wean them off the bottle when they turn 1 year old.
- Avoid smoky environments.
- Keep your child’s immunizations up to date.
- Wean your child from their pacifier by the time they are 1 year old.
The American Osteopathic Association also recommends nursing your baby, if possible, since it can help reduce the incidence of middle ear inflammations.