Ear Infections - Otitis Media

Ear infections are among the most common illnesses in babies and young children. Three out of four children experience otitis media by the time they are 3 years old. Most often, the infection affects the middle ear and is called otitis media. The tubes inside the ears become clogged with fluid and mucus. This can affect hearing, because sound cannot get through all that fluid.

Often, ear infections go away on their own, but your health care provider may recommend pain relievers. Severe infections and infections in young babies may require antibiotics. Children who get frequent infections may need surgery to place small tubes inside their ears. The tubes relieve pressure in the ears so that the child can hear again.

Are there different types of otitis media?

Yes. There are two main types. The first type is called acute otitis media (AOM). This means that parts of the ear are infected and swollen. It also means that fluid and mucus are trapped inside the ear. AOM can be painful.

The second type is called otitis media with effusion (fluid), or OME. This means fluid and mucus stay trapped in the ear after the infection is over. OME makes it harder for the ear to fight new infections. This fluid can also affect your child's hearing.

How does otitis media happen?

Otitis media usually happens when viruses and/or bacteria get inside the ear and cause an infection. It often happens as a result of another illness, such as a cold. If your child gets sick, it might affect his or her ears.

It is harder for children to fight illness than it is for adults, so children develop ear infections more often. Some researchers believe that other factors, such as being around cigarette smoke, can contribute to ear infections.

What's happening inside the ear when my child has an ear infection?

When the ears are infected the Eustachian tubes become inflamed and swollen. The adenoids can also become infected.

  • The eustachian tubes connect the middle ear to the nose. They keep air pressure stable in the ear. These tubes also help supply the ears with fresh air.

  • The adenoids are located in the back of the nose near the Eustachian tubes. Adenoids are like tonsils, lymphatic tissue, that help fight infections.

Swollen and inflamed Eustachian tubes often get clogged with fluid and mucus from a cold, sinus problem or enlarged adenoids. If the fluids plug the openings of the eustachian tubes, air and fluid get trapped inside the ear. These tubes are smaller and straighter in children than they are in adults. This makes it harder for fluid to drain out of the ear and is one reason that children get more ear infections than adults. The infections are usually painful at the beginning but may be asymptomatic and cause only hearing loss and speech problems.

Can otitis media affect my child's hearing?

Yes. An ear infection can cause temporary hearing problems. Temporary speech and language problems can happen, too. If left untreated, these problems can become more serious.

An ear infection affects important parts in the ear that help us hear. Sounds around us are collected by the outer ear. Then sound travels to the ear drum and then to the middle ear, which has three tiny bones and is filled with air. After that, sound moves on to the inner ear. The inner ear is where sounds are turned into electrical signals and sent to the brain. With ear infections, hearing is affected because sound cannot get through the middle ear that is filled with fluid.

How do I know if my child has otitis media?

It is not always easy to know if your child has an ear infection. Sometimes you have to watch carefully. Your child may get an ear infection before he or she has learned how to talk. If your child is not old enough to say, "My ear hurts," you need to look for other signals that there is a problem.

Here are a few signs your child might show you if he or she has otitis media:

  • Does she tug or pull at her ears?
  • Does he cry more than usual?
  • Do you see fluid draining out of her ears?
  • Does he have trouble sleeping?
  • Can she keep her balance?
  • Does he have trouble hearing?
  • Does she seem not to respond to quiet sounds?
A child with an ear infection may show you any of these signs. If you see any of them, call a doctor.

What will a doctor do?

Your doctor will examine your child's ear. The doctor can tell you for sure if your child has an ear infection. The doctor may also give your child medicine. Medicines called antibiotics are sometimes given for ear infections. It is important to know how they work. Antibiotics only work against organisms called bacteria, which can cause illness. Antibiotics are not effective against viruses, such as those associated with a cold. In order to be effective, antibiotics must be taken until they are finished. A few days after the medicine starts working, your child may stop pulling on his or her ear and appear to be feeling better. This does not mean the infection is gone. The medicine must still be taken. If not, the bacteria can come back. You need to follow the doctor's directions exactly. Your doctor may also give your child pain relievers, such as acetaminophen.

Will my child need surgery?

Some children with otitis media need surgery. The most common surgical treatment involves having small tubes placed inside the ear. This surgery is called a myringotomy and ventilation tube insertion. It is recommended when fluids from an ear infection stay in the ear for several months of in children who get repeated ear infections. The operation will require anesthesia.

In a myringotomy, a surgeon makes a small opening in the ear drum. Then a tube is placed in the opening. The tube works to relieve pressure in the clogged ear so that the child can hear again. Fluid cannot build up in the ear if the tube is venting it with fresh air.

After a period of time the tubes will fall out on their own. In rare cases, a child may need to have a myringotomy more than once. Tubes last from a couple of months to a few years, depending on what type of tube is place.

What else can I do for my child?

Here are a few things you can do to lower your child's risk of getting otitis media. The best thing you can do is to pay attention to your child. Know the warning signs of ear infections, and be on the look out if your child gets a cold. If you think your child has an ear infection, call the doctor. Do not smoke around your child or in your home. Smoking places children at high risk for developing ear infections and other medical problems. An allergy evaluation may be beneficial.

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