Ear Infections

Otitis media is an infection of the middle ear (the space behind the eardrum). In most cases, the infection is preceded by an allergy or respiratory infection that leads to swelling and congestion in the nose, throat and eustachian tube (the long narrow tube through which fluids drain from the middle ear). The eustachian tube can become blocked, impeding the flow of fluids out of the middle ear.

The swelling and inflammation associated with an ear infection can cause fever, headache, ear pain, irritability and difficulty sleeping. An infant or young child may tug or pull at his/her ear. In addition, the middle ear fluid remains stagnant, becoming a breeding ground for microorganisms, like bacteria and viruses. In some cases, fluid collects behind the eardrum, but doesn't cause any pain. This condition can last for several months at a time and is called, otitis media with effusion.

Researchers say 90 percent of children in the U.S. have at least one episode of otitis media before they turn three. The condition leads to more than 5 million visits to physicians' offices annually and is the leading reason for antibiotic prescriptions for American children. Experts say children tend to be more prone to ear infections because their eustachian tubes are shorter and more horizontal or straight. Thus middle ear fluid doesn't drain as readily and can back up into the ear or clog the tube.

Treating Middle Ear Infections

Many ear infections clear up on their own. Those that don't are sometimes treated with antibiotics. However, health care experts have been urging judicious use of antibiotics to reduce the development of bacteria that are resistant to the most common antibiotics.

Margaretha Casselbrant, M.D., Ph.D., Pediatric Otolaryngologist with Children's Hospital of Pittsburgh says children with ear infections should be carefully monitored. Some infections can become chronic, leading to hearing problems, which, in young children, could interfere with normal speech development. Casselbrant says she has found that children with chronic or recurrent ear infections may also have balance problems.

Children who have frequent ear infections (three or more in a six month period) or hearing, speech or balance problems related to the infections may be referred for ear tubes (called myringotomy or tympanostomy tubes). The tubes are miniature cylinders with a tiny hole in the middle. A tiny incision is made into the eardrum and the ear tube is placed into the opening. Once in place, air flowing through the hole in the ear tube equalizes the pressure and reduces inflammation inside the ear.

The American Academy of Otolaryngology - Head and Neck Surgery estimates more than one-half million ear tube surgeries are performed on children in the U.S. each year. The average age at the time of the surgery is three. In most cases, the tubes fall out on their own after about a year.

For general information on ear infections or ear tubes: American Academy of Otolaryngology - Head and Neck SurgeryAmerican Academy of PediatricsNational Institute on Deafness and Other Communication Disorders