Doctors should carefully evaluate ear infections in infants fewer than 3 months old, and consider more serious infections, such as meningitis.
While severe cases of recurrent acute otitis media or persistent otitis media with effusion (OME) are associated with impaired hearing for a period of time, the long-term consequences resulting from this hearing loss may not be significant in most children.
Hearing loss in children may temporarily slow down language development and reading skills. However, uncomplicated chronic middle ear effusion generally poses no danger for developmental delays in otherwise healthy children. As the majority of chronic ear effusion cases eventually clear up on their own, many doctors recommend against placement of tympanostomy tubes for most children.
Rarely, patients with chronic otitis media develop involvement of the inner ear. In these situations hearing loss can potentially be permanent. Most of these patients will also have problems with vertigo.
Serious complications or permanent physical injuries from ear infections are very uncommon, but may include:
Before the introduction of the conjugate pneumococcal vaccine, mastoiditis (an infection in the bones located in the skull), was a serious, albeit rare, complication of otitis media. The condition is difficult to treat and requires intravenous antibiotics and drainage procedures. Surgery may be necessary.
If pain and fever persist in spite of antibiotic treatment of otitis media, the doctor should check for mastoiditis. Most cases of mastoiditis are generally not associated with ear infections.
Impaired Balance. Some studies have indicated that children with chronic OME have problems with motor development and balance.
Facial Paralysis. Very rarely, a child with acute otitis media may develop facial paralysis, which is temporary and usually relieved by antibiotics or possibly drainage surgery. Facial paralysis may also occur for patients with chronic otitis media and a cholesteatoma (tissue in the middle ear). Surgery is often necessary to correct this condition.
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