Otitis Media

What is otitis media?
Otitis media is infection or inflammation located in the middle ear.

About 75 percent of children have at least one episode of otitis media by the time they are three years of age. Nearly half of these children have three or more infections by the time they are age three.

Otitis media can also affect adults, although it is primarily a disease that occurs in children.

What causes otitis media?
Inflammation usually begins when infections due to sore throats, colds, or other respiratory problems, spread through the eustachian tube, which becomes blocked causing fluid to build up in the middle ear.

What are the symptoms of otitis media?
The following are the most common symptoms for otitis media, however, individuals may experience symptoms differently.

Common signs of otitis media in children include:

• pain
• unusual irritability
• difficulty sleeping or staying asleep
• tugging or pulling at one or both ears
• fever
• fluid draining from ear(s)
• loss of balance
• hearing difficulties

The symptoms of otitis media may resemble other conditions or medical problems, such as ear ache caused by teething or blocked eustachian tubes from colds or allergies. Consult a child's physician for a diagnosis.

What complications may result from otitis media?
In addition to the symptoms of otitis media listed above, untreated otitis media can result in:

• infection in other parts of the head
• permanent hearing loss
• problems with speech and language development

What are the risk factors for otitis media?
There are certain factors that seem to increase the incidence of otitis media in some children. These include:

• age - infants and young children are more at risk
• gender - more boys seem to get ear infections than girls
• heredity
• children with frequent colds or allergies
• children living in a home where cigarettes are smoked
• children who are nursed with a bottle, especially while lying down

Can otitis media be prevented?
Cold and allergy medications do not appear to prevent otitis media. And, currently, there is no vaccine that can prevent the disease. However, children who have frequent ear infections sometimes receive preventive treatments, including:

• low-dose antibiotic therapy
• surgically inserted tubes to drain fluid, or prevent it from collecting, from the middle ear

Most children usually stop having multiple ear infections by the time they are about four years old.

How is otitis media diagnosed?
In addition to a complete medical history and physical examination, the child's physician will inspect the outer ear(s) and eardrum(s) using an otoscope. The otoscope is a lighted instrument that allows the physician to see inside the ear. A pneumatic otoscope blows a puff of air into the ear to test eardrum movement.

A tympanometry, a test that allows for air and sound to be directed into the middle ear, may also be performed.

A hearing test may be prescribed for a child with frequent ear infections, hearing loss that lasts more than six weeks, or fluid in the middle ear for more than three months.

Treatment for otitis media:
Specific treatment will be determined by the child's physician(s) based on:

• patient's age, overall health, and medical history
• extent of the disease
• expectations for the course of the disease
• patient's tolerance for specific medications, procedures, or therapies
• patient's or parent's opinion or preference

Treatment may include:

• antibiotic medication
• medication for pain
• myringotomy - surgery to insert tubes to ventilate the middle ear and keep air pressure level