An infection of the middle ear (space behind the eardrum where small vibrating bones are located) is known as an ear infection or acute otitis media. This condition can impact anyone but children are more prone to develop it.
Commonly, ear infections go away on their own and do not need treatment. That’s why the treatment usually starts with pain relievers and monitoring. In some cases, physicians may prescribe antibiotics to treat infections. In addition, recurrent ear infections can provoke dangerous complications and hearing issues.
Symptoms
The symptoms usually appear fast and are different among people. Check below some examples:
Symptoms in Children
- Sleeping problems
- Loss of balance
- Fussiness
- Ear pain
- Hearing problems
- High fever
- Fluid that drains from the ear
- Headaches
- Loss of appetite
Symptoms in Adults
- Trouble hearing
- Fluid in the ear
- Ear pain
It is advised to seek medical care immediately if the symptoms last more than 24 hours or are severe, or if your child experiences respiratory problems.
Causes
There are different causes of ear infections such as bacteria or viruses. In most cases, these infections occur due to other health conditions including cold, flu, or allergies. Previous conditions provoke swelling and congestion of the nasal passages, throat, and Eustachian tubes.
Eustachian Tubes
These small and narrow tubes begin from the middle of the ear to the back of the throat (behind the nasal passages). The end of the tubes (located in the throat end) open and close to refresh the air in the ear, remove normal secretions from the middle ear, and regular air pressure.
If these tubes become swollen it may lead to buildup of the fluid in the ear. Thus, the fluid can become infected, leading to ear infection symptoms. Moreover, in children, these Eustachian tubes are narrower and more horizontal. As a result, it is more difficult for them to drain fluid and can become clogged more easily.
Adenoids
Experts believe that adenoids (certain small pads located in the back of the nose) play an important role in the body’s defense (immune system) activity. These adenoids are located near the Eustachian tube opening. Swelling of the adenoids can block the tubes and cause ear infections.
Check below also some middle ear conditions that are linked with ear infections or cause similar issues as middle ear problems:
- Chronic otitis media with effusion – This condition happens when the fluid stays in the ear and continues to return but without viral or bacterial infections. It makes children more likely to develop new ear infections.
- Chronic suppurative otitis media – This is a serious ear condition that does not disappear with a usual treatment and can lead to an eardrum hole.
- Otitis media with effusion – It commonly happens due to fluid buildup after an ear infection. Sometimes, otitis media with effusion (fluid buildup) occurs due to dysfunction or noninfectious blockage of the Eustachian tubes.
Risk Factors
- Age – Toddlers aged between 6 months and 2 years are more likely to develop ear infections because of narrowed Eustachian tubes.
- Infant feeding – Those who drink from a bottle (especially lying down) instead of the mother’s breast are more prone to develop ear infections.
- Seasonal factors – Commonly, ear infections appear during the fall and winter. Furthermore, if you have a seasonal allergy you are at increased risk of developing ear infections.
- Poor air quality – An increased risk of ear infections have people who smoke or are exposed to high air pollution levels.
- Alaska Native heritage
- Cleft palate – Some children with cleft palate have certain differences in the muscle and bone structure that make it more challenging for Eustachian tubes to remove fluid.
What Are The Possible Ear Infection Complications?
Complications usually occur in people with recurrent ear infections. Examples include:
- Impaired hearing – This complication involves a mild hearing loss and usually comes and goes with an ear infection. After an ear infection clears the hearing often improves. However, those who suffer from ear infections again and again may experience permanent damage to the middle ear.
- Speech or developmental delays – Infants and children can experience developmental and social skills problems and delays in speech when hearing is temporarily or permanently impaired.
- Infection spreading – If you do not receive treatment for ear infections, it may lead to the spread of the infection to other tissues. As a result, it may lead to mastoiditis (infection of the mastoid) or even meningitis (infection of the brain or its surrounding tissues).
- Eardrum tearing – Generally, the eardrum tears heal within 3 days but sometimes surgery is needed.
Prevention
Check below some tips that could help to prevent ear infections:
- It is advised to teach your children to wash their hands thoroughly and avoid sharing eating utensils. This will help to prevent conditions such as common colds and others.
- You should avoid secondhand smoke
- It is recommended to breastfeed your child for at least 6 months if it is possible because breastmilk has different antibodies that help to protect your child from ear infections.
- Discuss with your healthcare professional about vaccinations.
Diagnosis
Physicians usually diagnose this condition by performing a physical examination and tests. They can also use an otoscope to look inside the ears, throat, or nasal passages and a stethoscope to listen to your breath.
What is a Pneumatic Otoscope?
This is a special instrument that usually physicians use to diagnose ear infections. With a pneumatic otoscope, they can puff air against the eardrum, and in normal circumstances, it should move. When a fluid buildup is present the eardrum will not move.
Check below some tests usually done to confirm an ear infection:
- Tympanometry – This test is usually performed by doctors to measure the eardrum movement.
- Acoustic reflectometry – It measures the reflected sound from the eardrum. In normal cases, the eardrum absorbs most of the sounds but when a fluid buildup is present, more sound will be reflected.
- Tympanocentesis – This test is performed rarely and it involves a small tube that pierces the eardrum to drain fluid. Thereafter, this fluid is sent to the laboratory to check for bacteria and viruses. It usually helps to get proper treatment, especially if you do not respond to the previous one.
- Other tests – Your physician may direct your child to different healthcare specialists (including an audiologist, speech therapist, or developmental therapist) to test for hearing, speech skills, and developmental abilities if frequent ear infections or fluid buildup occur.
Treatment
Sometimes, an ear infection goes away on its own and does not need treatment. In such cases, the symptoms will improve within several days and infection disappears during 1-2 weeks without treatment.
Pain Management
To reduce pain, physicians usually recommend the following medicines. Examples include:
- Painkillers – Healthcare professionals usually recommend nonprescription Acetaminophen or Ibuprofen. Additionally, do not give your children Aspirin, especially if they recover from chickenpox or flu-like symptoms because it may cause a serious health condition called Reye syndrome.
- Anesthetic drops – These drops can help to reduce pain if you do not have a hole or tear in the eardrum.
Antibiotics
Commonly, doctors prescribe antibiotics for children 6 months of age or older with middle ear pain in one or both ears that lasts more than 48 hours and a body temperature of 102.2F (39 C). Keep taking antibiotics even if the symptoms disappear. Otherwise, it may lead to a return of the infection and resistance of the bacteria to these medicines. If you forget to give your child a dose, discuss it with your healthcare professional.
Ear Tubes
This treatment option is usually recommended by doctors if you experience chronic otitis media (frequent long-term ear infections) or otitis media with effusion (persistent fluid buildup in the ear after the infection goes away). It involves a small hole in the eardrum in which doctors place a small tube (tympanostomy tube) that helps to ventilate the middle ear. These small tubes stay in the ear for up to 18 months or longer and after that fall out on their own. In most cases, the eardrum closes after ear tubes fall or are removed.
Frequently Asked Questions
Can an ear infection go away on its own?
Yes, approximately all ear infections go away without treatment within 2 weeks. In case the symptoms last more than a few days, you may need treatment.
What are the main symptoms of ear infections?
- Ear pain
- Lack of energy
- Discharge from one or both ears
- Irritation and itching in and around ears
- Hearing problems
- High body temperature
Do not hesitate to see a doctor if you experience any of the previous symptoms.
What are the potential complications of an ear infection?
- Chronic infection
- Cholesteatoma
- Facial nerve problems
- Perforation of the eardrum
- Hearing loss that occurs either temporarily or permanently
Ask your healthcare provider if you have additional questions.
