A tube called the eustachian (say: "you-stay-shee-an") tube connects the middle ear with the back of the nose. Normally this tube lets fluid drain out of the middle ear. If bacteria or viruses infect the lining of the eustachian tube, the tube gets swollen and fills with thick mucus. This keeps the ear from draining normally. Sometimes bacteria can grow in the fluid, increasing pressure in the middle ear behind a bulging eardrum and causing pain.
The vibration of the eardrum causes the tiny bones in the ear to move. This movement sends the sound waves to the inner ear.
A tube called the eustachian (say: "you-stay-shun") tube connects the middle ear with the back of the nose. Normally this tube lets fluid drain out of the middle ear. If bacteria or viruses infect the lining of the eustachian tube, the tube gets swollen and fills with thick mucus. This keeps fluid in the ear from draining normally. Bacteria can grow in the fluid, increasing pressure behind the eardrum and causing pain.
The eustachian tubes can also become blocked because of allergies, a cold, or other infection. In other cases, the adenoids (glands near the ear) become enlarged and block the eustachian tubes. When the tubes are blocked, even if there is no infection, air in the middle ear space is gradually absorbed and this creates a vacuum or negative middle ear pressure. This negative pressure also often creates an achy discomfort, and can lead to fluid (effusion) in the middle ear and reduced hearing. Doctors call this whole pattern “eustachian tube dysfunction.” Learn more about eustachian tube dysfunction here.
Acute ear infections usually clear up within 1 or 2 weeks. Sometimes, ear infections last longer and become chronic. After an infection, fluid may stay in the middle ear. This may lead to more infections and hearing loss.
Ear infections may be more common in children because their eustachian tubes are shorter and more narrow than those of adults. Most children will have at least 1 ear infection by their third birthday.
Otitis media is a term that refers to an inflammation of the middle ear without indicating a specific cause of the condition. Conditions affecting the middle ear include acute otitis media and otitis media with effusion. Learn more about otitis media with effusion here.
Another type of ear infection involves the outer ear and ear canal. Swimmer’s ear or otitis externa is caused by water irritating the skin inside the ear. Learn more about otitis externa (swimmer’s ear) here.
The most common symptoms of an acute middle ear infection (otitis media) are ear pain and fever. If your child is too young to tell you what hurts, he or she may cry or pull at his or her ear. Your child may also be irritable or listless, have trouble hearing, or not feel like eating or sleeping.
The treatment for ear infections may include any of the following:
The. U.S. Food and Drug Administration (FDA) advises against the use of ear candles. Ear candles can cause serious injuries and there is no evidence to support their effectiveness. For more information, please visit the FDA Web site.
Your child may need antibiotics if fluid is still there after a few months and is causing hearing loss or problems in both ears. For this reason, your child's ears should be checked a few months after an ear infection. If the fluid is still there, a hearing test may be the next step. Your doctor may also recommend antibiotics if your child is under 6 months of age or gets frequent middle ear infections.
Giving your child unnecessary antibiotics can be harmful. After each course of antibiotics, the germs in the nose and throat are more likely to become resistant. Resistant germs can't be killed by the usual antibiotics. More expensive and powerful antibiotics have to be used. Some of these antibiotics must be given in the hospital and their side effects can be very unpleasant or even dangerous. Since fluid in the ears doesn't usually bother children, it's better to wait and only give antibiotics when they are necessary.
If the fluid stays for more than a few months, your doctor may want to check your child's hearing. Your doctor may recommend ear tubes (also called tympanostomy tubes) to drain the fluid. Ear tubes may also decrease the number of ear infections your child gets.
Ear tubes are tiny plastic tubes that help balance the pressure in your child's ears. They allow air into the middle ear so that fluid can drain out down the eustachian tube. They're put into the eardrum (which is also called the tympanic membrane) during surgery and stay in place for an average of 6 to 9 months.
The tubes are usually left in place until they fall out on their own or your doctor decides your child no longer needs them. Sometimes, another set of tubes may be needed.
Placing tubes in the ears requires an operation and has some risks. Your child will need general anesthesia when the tube is inserted. Your doctor will talk with you about the risks if he or she thinks your child needs ear tubes.
Your doctor will tell you how long and how often to use your eardrops. Warm the bottle in your hands before putting the drops in your ear. Using warm eardrops may prevent discomfort when the drops go in. Moving the earlobe back and forth after putting the drops in will also help the medicine go deep into the ear canal.
Middle ear infections and fluid in the ear are the most common causes of temporary hearing loss in children. Children who have ongoing problems with hearing may have trouble developing their speech and language skills. For this reason, it is important to talk with your doctor if your child has repeated ear infections.
Persistent ear infections can cause damage to the structures in the middle ear, which can result in permanent hearing loss. However, this is not common.
Some children seem to get many ear infections. If your child has had 3 ear infections in 6 months or 4 in 1 year, your doctor may suggest that your child take a low dose of antibiotic every day, usually during the winter, when these infections are most common.
Your doctor may want to see your child a few times when he or she is taking the antibiotic to make sure another ear infection does not happen.
Written by familydoctor.org editorial staff