Ear infection (middle ear)
Ear infection (middle ear)
An ear infection (acute otitis media) is most often a bacterial or viral infection that affects the middle ear, the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear. Children are more likely than adults to get ear infections.
Ear infections frequently are painful because of inflammation and buildup of fluids in the middle ear.
Because ear infections often clear up on their own, treatment may begin with managing pain and monitoring the problem. Ear infection in infants and severe cases in general often require antibiotic medications. Long-term problems related to ear infections — persistent fluids in the middle ear, persistent infections or frequent infections — can cause hearing problems and other serious complications.
The onset of signs and symptoms of ear infection is usually rapid.
When to see a doctor
An adult with ear pain or discharge should see a doctor as soon as possible.
An ear infection is caused by a bacterium or virus in the middle ear. This infection often results from another illness — cold, flu or allergy — that causes congestion and swelling of the nasal passages, throat and eustachian tubes.
Role of eustachian tubes
Swelling, inflammation and mucus in the eustachian tubes from an upper respiratory infection or allergy can block them, causing the accumulation of fluids in the middle ear. A bacterial or viral infection of this fluid is usually what produces the symptoms of an ear infection.
Ear infections are more common in children, in part, because their eustachian tubes are narrower and more horizontal — factors that make them more difficult to drain and more likely to get clogged.
Role of adenoids
Because adenoids are near the opening of the eustachian tubes, inflammation or enlargement of the adenoids may block the tubes, thereby contributing to middle ear infection. Inflammation of adenoids is more likely to play a role in ear infections in children because children have more active and relatively larger adenoids.
Inside your ear
The middle ear includes three small bones — the hammer, anvil and stirrup. The middle ear is separated from your external ear by the eardrum and connected to the back of your nose and throat by ...
Risk factors for ear infections include:
Most ear infections don't cause long-term complications. Frequent or persistent infections and persistent fluid buildup can result in some serious complications:
Preparing for your appointment
You'll likely begin by seeing your family doctor or your child's pediatrician. You may be referred to a specialist in ear, nose and throat (ENT) disorders (otolaryngologist) if the problem has persisted for some time, is not responding to treatment or has occurred frequently.
If your child is old enough to respond, before your appointment talk to the child about questions the doctor may ask and be prepared to answer questions on behalf of your child. Questions for adults will address most of the same issues.
Tests and diagnosis
Your doctor can usually diagnose an ear infection or another condition based on the symptoms you describe and an office exam. The doctor will likely use a lighted instrument (an otoscope) to look at the ears, throat and nasal passage. He or she will also listen to your child breathe with a stethoscope.
What a diagnosis means
Treatments and drugs
Most ear infections resolve without treatment with antibiotics. What's best for your child depends on many factors, including your child's age and the severity of symptoms.
A wait-and-see approach
Some evidence suggests that treatment with antibiotics might be beneficial for certain children with ear infections. Talk to your doctor about the benefits of antibiotics weighed against the potential side effects and concern about overuse of antibiotics creating strains of resistant disease.
Even after symptoms have improved, be sure to use all of the antibiotic as directed. Failing to do so can result in recurring infection and resistance of bacteria to antibiotic medications. Talk to your doctor or pharmacist about what to do if you accidentally skip a dose.
During an outpatient surgical procedure called a myringotomy, a surgeon creates a tiny hole in the eardrum that enables him or her to suction fluids out of the middle ear. A tiny tube (tympanostomy tube) is placed in the opening to help ventilate the middle ear and prevent the accumulation of more fluids. Some tubes are intended to stay in place for six months to a year and then fall out on their own. Other tubes are designed to stay in longer and may need to be surgically removed.
The eardrum usually closes up again after the tube falls out or is removed.
Treatment for chronic suppurative otitis media
The following tips may reduce the risk of developing ear infections:
Last Updated: 2013-04-20
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