Otitis media is a common and painful infection of the middle ear that is common in young children, but can also affect older children and adults.
Otitis media ear infection often accompanies a common cold, the flu, or another type of respiratory infection. This is because the middle ear is connected to the upper respiratory tract by a tiny channel known as a Eustachian tube.
Most parents are frustratingly familiar with ear infections and they are one of the most common reasons for trips to the doctor. Ear infections can lead to more serious complications including mastoiditis (a rare inflammation of a bone adjacent to the ear), hearing loss, perforation of the eardrum, meningitis, facial nerve paralysis, and possibly hearing loss.
What causes an ear infection?
Cells in the middle ear make a fluid that, among other things help keep out invading organisms. Normally, the fluid drains out through the Eustachian tube and into the throat. But if the Eustachian tub becomes swollen or blocked the fluid can become trapped in the middle ear, forming a breeding ground for bacteria and viruses that can cause the area to become inflamed and infected. This tube lies in a more horizontal position and is shorter in children, which may put them at greater risk of infection. To the doctor the eardrum of an infected patient appears red and bulging.
The most common cause of an ear infection is an upper respiratory viral infection, such as a cold or the flu. These disorders can make the Eustachian tube so swollen that the middle ear fluid cannot drain. Allergies to pollen, dust, animals or food, can produce the same effect as a cold or flu, as can smoke, fumes and other environmental toxins. Bacteria can cause an ear infection directly, but usually these organisms come on the heels of a viral infection or an allergic reaction, quickly finding their way into the warm, moist environment of the middle ear. Among the bacteria most often found in infected middle ears are the same varieties responsible for many cases of sinusitis, pneumonia and other respiratory infections.
Ear infections occur in various degrees of severity. A single, isolated case is called acute ear infection. If the condition clears up but comes back as many as three times in a six-month period (or four times in a single year), it is known as recurrent ear infection. This usually indicates the Eustachian tube isn’t working correctly. If it continues for weeks without clearing up, it is called chronic ear infection.
In recent years, scientists have identified the characteristics of people most likely to suffer recurrent middle ear infections: males; individuals with a family history of ear infections; babies who are bottle-fed (breastfed babies get fewer ear infections); children in nurseries; people living in households with tobacco smokers; and people with poor or damaged immune systems or chronic respiratory diseases such as cystic fibrosis and asthma.
What are the symptoms of an ear infection?
In adults:
- Earache (either a sharp, sudden pain or a dull, continuous pain)
- Fever and chills
- A feeling of fullness in the ear
- Nausea may accompany an earache
- Muffled hearing
- Ear drainage
In children:
- Tugging at the ear
- Poor sleep
- Fever
- Irritability, restlessness
- Ear drainage
- Nasal discharge
- Diminished appetite
- Crying at night when lying down
Seek medical advice about an ear infection if:
- Body temperature rises above 38C; a fever signals the possibility of a more serious infection (especially in babies and young children).
- Your child is inconsolable.
- Your or your child frequently develop ear infections; repeated bouts can lead to hearing loss or more serious infections.
- You or your child has hearing problems; the infection may be related.
- You suspect that your young child has an ear infection; it is often difficult for a parent to tell if a child is having problems with his or her ears.
How are ear infections diagnosed?
If you or your child has an earache accompanied, in some instances but not always, by a stuffy or runny nose and a sore throat and fever, it is likely that the problem is an ear infection. Your GP will probably examine the eardrum with an instrument called an otoscope for signs of infection.
Sometimes the ear specialist at the hospital may also check for blockage of the middle ear using a pneumatic otoscope, which blows a little air at the ear drum. This air should cause the eardrum to move back and forth. If fluid is present or the canal is blocked, the eardrum will not move as readily.
Another test for ear infections is tympanometry, which uses sound and air pressure to check for fluid in the middle ear. If needed and audiologist will perform a hearing test to determine if there is hearing loss.
To check for a bacterial ear infection, a doctor may, on rare occasions, make an opening in the eardrum, draw out a sample of fluid from the middle ear, then culture the sample in a laboratory. This more invasive measure is usually used only for serious or particularly stubborn infections.
What are the treatments for ear infections?
The goal of treatment for most doctors and therapists is to rid the middle ear of infection before more serious complications set in. Treatment usually involves eliminating the causes of the ear infection, killing any invading bacteria, boosting the immune system, and reducing swelling in the Eustachian tubes.
Conventional medicine for ear infections.
An ear infection is often caused by a virus, in which case the only relief doctors can offer is treatment of the symptoms. This may involve trying to reduce swelling in the Eustachian tubes with a decongestant.
To ease the pain of an ear infection, your doctor may recommend a painkiller, typically paracetamol or ibuprofen, which also helps reduce a fever. Aspirin should not be given to children under 16 years of age because of the threat of Reye’s Syndrome.
Routine use of antibiotics is not recommended to treat otitis media since studies have shown that antibiotics do not speed up recovery and that most ear infections are viral in origin and therefore will not respond to antibiotics.
Antibiotics are recommended in certain circumstances such as if symptoms are not improving after four days, or if a child has a serious underlying health problem.
For recurrent ear infections doctors may suggest surgery to eliminate infection or drain the middle ear. One technique, called myringotomy, involves piercing the eardrum to release fluid from the middle ear. If the Eustachian tubes become completely closed off due to swelling, a surgeon may insert a ventilation tube (grommet) through the ear drum to help fluid drain and to help dry out the space behind the ear drum, reduce pain, and improve hearing. This procedure, called tympanostomy, rarely leads to infection and scarring but is intended to provide long lasting positive results. If recurring infections in the adenoids or tonsils cause repeated ear infections, a doctor may suggest having these tissues removed.
Home remedies for ear infections.
You can provide a great deal of ear infection symptom relief at home. Try these tips:
- Many find that warmth, perhaps from a warm compress, brings comfort. Steam inhalations may also help, but take care not to burn yourself; protect your eyes as well.
- Gargling with salt water helps soothe an aggravated throat and helps clear the Eustachian tubes
- Holding your head erect can help drain your middle ear
How can I prevent an ear infection?
Because bottle-fed babies are more likely to get ear infections, it is better to breast feed your baby for the first 6 months, if possible, to lessen the risk of ear infections. Also, remove as many environmental pollutants from your home as you can, including dust, cleaning fluid and solvents, and tobacco smoke. Reduce your or your child’s exposure to people with colds and control allergies.
