Otitis Media
Also known as: ear infection
What is it?
Otitis media is an infection of the middle ear.
Otitis media can be acute, which means symptoms
begin suddenly and are severe; chronic, which
means they occur frequently, usually lasting for
one month or longer; and with effusion, which
means there is fluid behind the ear drum.
Who gets it?
Anyone can get otitis media, which often occurs
as a complication of a cold or allergies. People
who swim frequently may get recurring ear
infections, also known as swimmer’s ear. Otitis
media is very common in children. People who are
frequently exposed to cigarette smoke have a
higher risk of getting ear infections.
What causes it?
The ear consists of the outer, middle, and
inner ear. The middle ear is located behind the
eardrum, and is connected to the back of the nose
by a small tube called the eustachian tube. This
tube lets air into the middle ear and allows
fluids to drain. Every time you swallow, the
eustachian tube opens and keeps pressure equal on
each side of the eardrum. However, allergies and
viral or bacterial infections that irritate the
nasal passages can cause swelling in the
eustachian tube. The swelling limits its ability
to drain fluids, which build up in the middle ear
and create pressure. It’s also easy for bacteria
to grow in the trapped fluid.
What are the symptoms?
Symptoms of an ear infection include pain and
pressure in the ear. Pain may be greater when
lying down, which creates more pressure within the
ear. Acute otitis media is usually accompanied by
severe pain. Chronic ear infections are usually
less painful, but can create a permanent hole in
the eardrum. Fluid trapped in the ear may cause a
popping or cracking sound when you swallow. Otitis
media symptoms may also include fever, headache,
nausea, vomiting, dizziness, and temporary
difficulty with hearing. The pressure on the
eardrum can cause the eardrum to burst, releasing
blood-tinged or greenish-yellowish fluid from the
ear. Repeated ear infections can damage parts of
the middle ear and cause hearing loss. Bacteria
from an ear infection can spread if untreated. If
it spreads to the mastoid bone, located behind the
ear, it can cause an infection called mastoiditis.
How is it diagnosed?
To diagnose an ear infection, your doctor will
take your medical history and perform a thorough
physical examination. He or she will use an
instrument called an otoscope to check the inside
of your ear for redness and swelling. The doctor
will attach a small tube to the otoscope, through
which he or she can blow a small puff of air to
check for movement of the eardrum. The doctor may
also use a procedure called tympanometry to check
for fluid in the middle ear. When ear infections
are chronic, your doctor may perform a procedure
called tympanocentesis, which involves making a
small hole in the eardrum to remove a sample of
middle ear fluid. This fluid is then cultured to
determine what type of bacteria is causing the
infections.
What is the treatment?
In most cases, ear infections are treated with
antibiotics, sometimes combined with
anti-inflammatory drugs. Your doctor may give you
eardrops, and recommend acetaminophen or
nonsteroidal anti-inflammatory drugs for pain.
Holding something warm against the ear, such as a
heating pad set on low, can also relieve pain.
With treatment, an ear infection usually clears up
within 10 days. People with chronic ear infections
may need to have a very small tympanostomy tube
inserted in the eardrum to drain fluids and
relieve pressure. This procedure is performed
under anesthesia on an outpatient basis. After a
few months, the tiny tubes fall out on their own.
While decongestants may relieve cold symptoms and
antihistamines provide allergy relief, neither
drug will cure an ear infection.
Self-care tips
f you or your child is diagnosed with an ear
infection, follow your doctor’s treatment
recommendations. It is important to finish the
entire course of antibiotics, even though you may
feel better within a few days. If you do not
finish the medication, there may be some remaining
bacteria that will cause the infection to come
back. Avoiding cigarette smoke can reduce your
risk of an ear infection. People with swimmer’s
ear should wear earplugs when swimming to prevent
water from entering the ear.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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