USF-COM
Department
of Family Medicine
Patient Education Information on...
Index of
Patient Education Topics
What is a middle
ear infection?
A middle ear infection, or otitis media, is
an infection found behind the eardrum. It can range from a collection
of fluid behind the eardrum, to a severe infection. There are several
term the doctor may use to describe the infection such as serous, which
means fluid; or purulent, which means producing pus.
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What causes middle
ear infections?
There is no one cause of these infections,
in fact there are many different causes. They most commonly follow
a cold, either bacterial or viral. Another common predisposition
to these infections is fluid that has collected behind the eardrum and
has been there for a some period of time.
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Who gets middle ear infections?
Middle ear infections are a common illness
among children. It is especially common in daycare settings, where
the child is more likely to encounter illnesses. It is also more
common in children that are chronically exposed to cigarette smoke.
Once children reach the age of six the frequency of middle ear infections
should begin to decrease, and these types of infections are almost never
seen in older children and adolescents.
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What are the symptoms
of a middle ear infection?
There is a wide range of symptoms. Some
of the more common symptoms are sharp pain and pressure in the affected
ear, as well as a fever. In young children and babies fever is the
most common symptom, and the pain will be evidenced by crankiness and tugging
at the infected ear. Other symptoms may be facial pain, nausea
and vomiting, diarrhea, and difficult sleeping.
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What are the complications
of a middle ear infection?
The most common problem is a burst ear drum.
The pressure and the fluid build up enough behind the ear drum to
cause it to burst releasing the fluid and the pressure. This may
cause alarm, but it relieves the pain and the ear drum will quickly heal
itself. Another complication is diminished hearing in the affected
ear. This deafness is short term and will correct itself after the
infection has resolved. If the child has long standing fluid behind
the eardrum, and recurring ear infections, there may be a more long-standing
diminishment of hearing in the affected ear. If this occurs while
the child is learning how to speak here may be minor delays in the child’s
language development.
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What should I,
as a parent, do for my child if he or she has symptoms?
There are several things you can do to help
your child before you take him or her to see their doctor. You can
give them over the counter medications such as Panadol, Tempra, or children’s
Tylenol. These medications will help relieve some of the pain as
well as the fever if one is present. You may also try to keep the
child’s head elevated to ease the pressure in the middle ear.
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What will doctor due
during the examination?
The doctor will look in your child’s ears
with a tool called an otoscope. This will allow the doctor to see
the eardrum. The eardrum may look rd and bulging. The doctor
may also see fluid behind the eardrum. The doctor may also use a
a small bulb attached to the otoscope, called an insufflation bulb, to
test the mobility of the child’s eardrums. When the doctor squeezes
the bulb air is forced into the ear canal. Normally the doctor would
see the eardrum move then this is done, but in a child with a middle ear
infection the drum moves very little, or not at all. Another way
to asses the movement of the eardrum is using a machine called a Tympanogram.
This basically does the same thing as the insufflation bulb, only now it
is connected to a computer that will more accurately describe the movement
of the eardrum. As mentioned above, there may be diminished hearing,
but none of these tests will evaluate the level of the child’s hearing.
To do this the doctor must perform a hearing screening test, either in
his office or in another facility.
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How is a middle ear
infection treated?
There are a few methods of treatment.
If the infection is mild the doctor may opt for treatment of the pain
with medications mentioned above and monitoring of the child to be
sure that the infection resolves.
If the infection is more severe, or has
worsened from mild to more severe, the doctor may opt to treat with antibiotics.
The antibiotics used for middle ear infections are very effective but can
cause some side effects such as diarrhea, or rash. The child should
start to improve within 48 hours of starting antibiotics, but it is important
to finish the full course of antibiotic.
If the child has long-standing fluid behind
the eardrum, or has recurrent infections tympanostomy tubes may
be placed in the eardrum. This is a simple procedure done in the
hospital. Your child will receive a general anesthetic that will
cause them to sleep, and then a small plastic tube will be inserted through
both eardrums. This will allow the ears to drain out any fluid,
and will allow pressure to equalize relieving any pain.
If the infections continue even with the
tubes a tonsillectomy or adenoidectomy may be suggested. However,
these procedures are more invasive and rarely produce results in young
children, often only being beneficial in adolescents and older children.
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How will middle ear
infections change my child’s activity?
Middle ear infections should have little effect
on you child’s activity. they will be able to enjoy the full host
of activities that they enjoyed before the infection. The exception
is that if the child has undergone placement of tubes he or she will have
to wear earplugs when bathing. The child will also have to wear earplugs
and a bathing cap, pulled down over the ears, when swimming.
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for more information on middle ear infections