Otitis Media (middle ear infection) - A guide to Hearing Loss

This is an infection of the middle ear which is caused by a build up of fluid (mucus) which then becomes infected by bacteria. This causes earache (not in all cases), fever and a general feeling of malaise. Air pressures also increase in the ear which causes muffled hearing. This condition is far more common in children than adults although it can effect all ages.

There are two types of otitis media: chronic and acute.

If the infection occurs in the outer ear then it is classed as otitis externa.

Causes of otitis media

There are several causes of otitis media which include ‘glue ear’, a head cold or a viral infection. Another possible trigger is a smoky environment or having a brother/sister with this condition.

But sometimes it happens for no apparent reason. Glue ear is a common ear condition in children in which the space in the middle ear becomes full of a thick, sticky fluid (similar to glue) which blocks the Eustachian tube and obstructs sound waves to and from the ear drum. This results in an inability to hear certain sounds or a muffling of sounds in general. And some sounds may not be heard at all. Glue ear is covered in more detail in our children and hearing loss section.

Symptoms of otitis media

These include: a discharge from the ear, fever, feelings of nausea and vomiting (in young children), lack of appetite and pain. Earache is another sign although this doesn’t occur in all cases.

The ear drum may perforate which will relieve earache caused by pain in this area. If this happens then mucus will be released and this will run out of the ear over a few days. The ear drum heals itself over a period of time.

If you are the parent of a baby or a toddler who you suspect has an ear infection then look for the following signs:

• Persistent crying
• Unable to settle
• Tries to grab or pull at their ears
• Feels sick or is actually sick
• High temperature
• Red in the face and sweaty

These are all signs of otitis media. Earache is another sign but this doesn’t always happen. Earache is a common feature of an ear infection but not all earaches are caused by an ear infection.

Confused? In other words, if your baby/toddler has earache but apart from that is fine then it doesn’t automatically mean that they have an ear infection. A head cold might be the reason for their earache rather than an ear infection or pain from another source, for example teething.

Treatment for otitis media

GP’s usually prefer to let nature take its course, so to speak, and let the infection clear up by itself. The body’s immune system is very good at doing this and usually gets rid of the infection after a few days.

They try to avoid prescribing antibiotics wherever possible due to the risk of reducing the resistance level of the patient to less serious infections. But, there are exceptions to this which include:

• Severe infection
• Infection has not cleared after 3 days
• Complications have set in
• The child is aged under 2

If antibiotics are not prescribed then painkillers such as Calpol or Disprol (for children) can help. These will ease any pain or discomfort as well as reducing the child’s temperature.

If your child is prone to repeated ear infections then a grommet may help. This is a tiny tube which is inserted into the ear drum to drain away excess fluid.