Article by Hearing Partners, contributed by Nur Nabila, Clinical Audiologist at Hearing Partners
Otitis media is an infection of the middle ear, which is the area located just behind the eardrum. Even though this is a common condition, children tend to be more susceptible to middle ear infections than adults.
In this article, we’ll explore the symptoms, causes, and treatment options for otitis media, and discuss possible prevention methods.
Symptoms of Otitis Media
Otitis media can manifest differently in adults and children, especially since children may not be able to express their discomfort well. Here are some symptoms to look out for:
| Children | Adults |
|---|---|
Causes of Otitis Media
Otitis media is commonly triggered by viral or bacterial infections in the upper respiratory system, affecting the Eustachian tube and adenoids. The accumulation of mucus can cause swelling or blockage of the Eustachian tube, while enlarged adenoids can obstruct it. When mucus fails to drain properly, the infection can spread to the middle ear.
Risk Factors for Otitis Media
Certain individuals are more susceptible to otitis media due to various risk factors. Understanding these factors can help in prevention and early intervention.
- Age: Middle ear infections are more common in children because their Eustachian tubes are narrower and more horizontal than those of adults and their adenoids are relatively larger.
- Immunity: Individuals with weaker immune systems, such as children and the elderly, may be predisposed to ear infections.
- Daycare: Children who attend daycare facilities are more likely to be exposed to infections, increasing their risk of otitis media.
- Bottle feeding and pacifier use: Bottle-fed infants and those who use a pacifier while lying down tend to have ear infections, putting them at greater risk for otitis media.
- Congenital conditions: Certain congenital conditions, such as cleft palate or Down syndrome, can predispose individuals to middle ear infections.
- History of allergies, acid reflux or ear infections: A history of drug allergies or acid reflux can increase the likelihood of developing otitis media. Moreover, those with a family history of ear infections are more likely to develop an ear infection.
- Environmental factors: Exposure to secondhand smoke can irritate the respiratory system and increase the risk of otitis media.
Treatment for Otitis Media
Otitis media often resolves on its own within 3 to 5 days. However, if symptoms persist or worsen, treatment may be necessary. One or a combination of the following treatments may be prescribed, depending on the severity and cause of the infection.
Over-the-counter pain medication
Your hearing care professional may suggest over-the-counter medications such as acetaminophen or ibuprofen to relieve discomfort. Additionally, they might provide a prescription for ear drops to help alleviate pain and inflammation.
Antihistamines or nasal decongestants
To ease symptoms related to upper respiratory infections, such as a runny or congested nose, antihistamines or nasal decongestants may be recommended.
Antibiotics
Antibiotics are not typically prescribed for middle ear infections. However, if your symptoms are severe and persistent, your doctor may prescribe this medication.
Tympanostomy
Tympanostomy is a brief surgical procedure performed by an Ear, Nose, and Throat (ENT) specialist. This procedure may be recommended if fluid persists in the ear for longer than 3 months and antibiotics have proven ineffective. In such cases, tympanostomy can help facilitate drainage and speed up recovery.
During this procedure, a small hole is made in the eardrum and a tiny metal or plastic tube is inserted through the eardrum. These tubes help facilitate air circulation and allow fluid to drain from the middle ear. They typically remain in place for 6 to 18 months and may either fall out naturally or require removal. Once the tubes are removed, the small hole in the eardrum will heal and close.
Preventing Otitis Media
You can lower the risk of developing a middle ear infection by taking preventive measures such as the following:
- Vaccinations: Staying up to date with vaccinations, including the flu and the pneumococcal vaccine, can help protect against infections that can lead to otitis media.
- Avoiding secondhand smoke: Minimise exposure to secondhand smoke, as it can irritate the respiratory system and increase the risk of ear infections.
- Good hygiene: Practise regular handwashing and good hygiene to reduce the spread of infections in general.
- Addressing health issues: Address and treat other health issues, such as acid reflux, as they can contribute to otitis media and worsen symptoms.
- Breastfeeding: For infants, breastfeeding can provide antibodies that enhance the immune system and reduce the likelihood of infections.
- Proper feeding position: When bottle-feeding infants, hold them in an upright position to prevent fluid from entering the Eustachian tube.
FAQs About Otitis Media
Are there different types of otitis media?
There are three main types of otitis media:
- Acute otitis media: This type manifests suddenly, causing inflammation and redness. The buildup of fluid and mucus in the ear often leads to symptoms like fever and ear pain.
- Otitis media with effusion: In this type, mucus and fluid (referred to as effusion) accumulate in the middle ear even after the initial infection has resolved. This can create a sensation of fullness in the ear and may affect hearing, although it can also occur without any noticeable symptoms.
- Chronic suppurative otitis media: This condition involves persistent middle ear infections that stem from recurrent infections or a perforated eardrum, typically caused by previous trauma or infection. It can result in hearing loss and may produce unpleasant smelling discharge.
When should I see a doctor for otitis media?
If your child is under 6 months old or if you observe any of these symptoms, you may wish to consult a doctor:
- Severe ear pain
- High fever
- Symptoms persisting for more than 1 to 3 months
- Fluid, pus, or bloody discharge from the ear
- Weakness in the face
- (For children) Difficulty eating or sleeping after a cold
What happens if I leave a middle ear infection untreated?
A middle ear infection often clears up by itself. However, if it doesn’t recover or keeps recurring, several complications can occur as described below.
- Hearing loss: Prolonged fluid buildup can interfere with normal hearing, potentially leading to temporary or permanent hearing loss.
- Chronic otitis media: Repeated infections can result in chronic otitis media, which is characterised by persistent fluid in the middle ear and requires medical intervention.
- Tympanic membrane perforation: Untreated infections can cause the eardrum to rupture, leading to a perforation that can result in pain and other complications.
- Mastoiditis: Occasionally, the infection can spread to the mastoid bone behind the ear, leading to mastoiditis, which is a serious condition that requires aggressive treatment.
Nur Nabila is a Clinical Audiologist at Hearing Partners. She has a Bachelor of Audiology with Honours from the International Islamic University Malaysia (IIUM). She is experienced in conducting adult and paediatric hearing tests, and helps with hearing aid selection and fitting to ensure users are matched with the right device.