CausesMiddle ear infections are also called otitis media, and most often just referred to as an ear infection. They are very common in children and sometimes occur in adults. They differ from outer ear infections, (Swimmer's Ear), not only in the part of the ear that becomes infected but symptomatically as well. Children are more prone to middle ear infections because of the shape and size of their eustachian (auditory) tube which becomes blocked and unable to drain. Trapped mucous and other debris can then become infected.
Many risk factors also contribute to the development of middle ear infections. Sometimes middle ear infections are accompanied by fluid in the ear; this is called serous otitis media. For a more in-depth look at what causes middle ear infections, or if you suspect you have one, you may wish to read:
The most common symptom of a middle ear infection is ear pain. Because middle ear infections occur so often in infants and small children, they may not be able to communicate this to you. It is necessary to recognize subtle clues that your child might be in discomfort. For more information please read:
- Symptoms of an Ear Infection
- Study Looks at How Parents Determine if Their Non-Talking Children Have an Ear Infection
Diagnosis/When to See a DoctorYou should see a qualified physician as soon as you suspect a middle ear infection. Middle ear infections are not difficult or painful to diagnose. The doctor simply needs to look inside the ear with a special instrument called an otoscope. If the doctor can see swelling, redness, drainage or anything else indicating an infection, then a middle ear infection will be diagnosed. Your doctor may also ask you questions about your health history because you are more likely to develop a middle ear infection if you've had a recent cold, experienced congestion from allergies or a cold, been around second hand cigarette smoke or if your infant has been fed while lying on his or her back. The following articles give more information on this process and when it is time to see a doctor.
- What Should I Do if My Child Develops an Ear Infection Over the Weekend?
- When Is Ear Drainage an Emergency?
- When to Get a Second Opinion
- Readers Respond: How Did You Find Out Your Child Had Fluid in Their Ears (Serous Otitis Media)
- What Is the Best ENT Treatment (when to see an ear, nose, throat specialist instead of a general practitioner)
TreatmentAs stated above, the most common treatment for a middle ear infection is oral antibiotics. However, if you are otherwise healthy and symptoms are not severe (painful) your doctor may decide to "wait and watch" before prescribing antibiotics. For a more in-depth look at treatment read:
- How Are Ear Infections Treated?
- Ear Infections: to Treat or Not to Treat?
- How to Use Ear Drops Correctly
Chronic middle ear infections are often treated surgically with a procedure called a myringotomy, where synthetic ear tubes are placed in the eustachian (auditory) tube to hold it open and prevent it from becoming plugged.
Managing SymptomsSeveral different medications are available to manage the symptoms of middle ear infections. The most common include over-the-counter pain relievers like acetaminophen and ibuprofen, but prescription medications to control pain are also occasionally used. At home, make sure you lay down in the correct position for the auditory tube to drain. Otherwise there will be a build up of pressure resulting in (sometimes severe) pain and making the possibility of a ruptured ear drum more likely. For more on positioning and things to do at home read:
- Managing Ear Pain
- Readers Respond: How to Calm Your Child When He Has an Earache
- How to Calculate the Right Dose of Acetaminophen for Your Child