Ear infections, also known as acute otitis media, are infections of the middle ear, the air-filled space behind the eardrum. They commonly affect children more than adults. Treatment usually involves pain management and monitoring, with antibiotics used in some cases.
Symptoms of ear infections include ear pain, tugging or pulling at the ear, trouble sleeping, excessive crying, trouble hearing or responding to sounds, loss of balance, fever, fluid drainage from the ear, headache, and loss of appetite. In adults, symptoms may include ear pain, fluid drainage, and hearing difficulties.
It is important to see a doctor if symptoms last for more than a day, occur in a child under 6 months of age, or if there is severe ear pain or unusual behaviour following a cold or respiratory infection. Other concerning symptoms include fluid or pus discharge from the ear.
Ear infections are caused by bacteria or viruses that infect the middle ear, often as a result of congestion and swelling caused by a cold, flu, or allergies. Eustachian tubes, which connect the middle ear to the throat, play a role in regulating air pressure, refreshing air, and draining fluid from the ear. Swollen eustachian tubes can become blocked, leading to fluid accumulation and infection. Adenoids, located near the eustachian tubes, can also contribute to blockages and infections, particularly in children.
Risk factors for ear infections include age (children between 6 months and 2 years are more susceptible), group child care, bottle-feeding, seasonal factors, poor air quality, Alaska Native heritage, and cleft palate.
Complications of recurring ear infections can include hearing impairment, speech or developmental delays, spread of infection to nearby tissues (mastoiditis or meningitis), and eardrum tears requiring surgical repair.
Prevention measures include preventing common colds, avoiding secondhand smoke, breastfeeding, and staying up to date with vaccinations.
Diagnosis is typically based on symptoms and a physical exam, including the use of a pneumatic otoscope to assess fluid behind the eardrum. Additional tests like tympanometry and acoustic reflectometry may be conducted for further evaluation.
Treatment options vary depending on the situation. A wait-and-see approach may be suitable for mild cases that often resolve on their own. Pain management can involve over-the-counter medications or anesthetic drops. Antibiotics may be prescribed for moderate to severe cases or certain age groups. In some instances, surgical placement of ear tubes (tympanostomy tubes) may be recommended to drain fluid from the middle ear.
Chronic suppurative otitis media, a persistent infection with a tear in the eardrum, is challenging to treat and often requires antibiotic drops. Close monitoring and follow-up appointments are important for children with frequent infections or persistent fluid in the middle ear. Regular hearing and language tests may be recommended.