|Ear infections can affect
any one, though children are particularly vulnerable to them.
But there are different types, and the possible treatment options
will depend on what type it is, and what might have caused it.
The medical term for a middle ear infection is otitis media. There
are three main types:
- acute otitis media
- chronic otitis media
- 'glue ear' (secretory otitis media,also known
otitis media with effusion)
The outer ear includes the parts of the ear that can be seen on
the side of the head, as well as the canal that leads into the
The middle ear contains three small bones that help sounds reach
the eardrum. A narrow tube (called the Eustachian tube) connects
the middle ear to the throat, and regulates the pressure in the
Otitis media affects the middle ear. It is very common in children
under the age of eight, but you can get it at any age, and it
can affect one or both ears. You are more likely to get otitis
media if it someone in your family has had it, or if you live
or work with people who smoke.
|Acute otitis media
This type of infection is often caused by bacteria associated
with a cold or sore throat, which can travel up the Eustachian
tube, causing infection. The infection can cause pus and bleeding,
and the eardrum may burst as a result of the pressure. In most
cases, a burst eardrum heals by itself.
Chronic otitis media
If the eardrum does not heal completely, or if it has been punctured
by a blow to the head, the ear becomes vulnerable to chronic otitis
media. This type is not as painful as the acute type, but it can
last for longer and the infection can occur over and over again.
Chronic otitis media can also be caused by a condition called
cholesteatoma, which causes an over-production of tissue in the
This can develop if the Eustachian tube gets blocked. If this
happens, the pressure inside the ear cannot be regulated. A sticky
fluid builds up inside the middle ear and affects hearing.
Blockage of the Eustachian tube may be caused by an infection,
an allergy, or by enlarged adenoids (cells at the back of the
throat which help fight infections).
Children are particularly vulnerable to glue ear because they
are less able than adults to fight off infections, and also because
their Eustachian tubes are shorter, lie in a more horizontal position,
and are more easily blocked. Children who get allergies and hay
fever are more susceptible, too.
|Acute otitis media
Symptoms of acute otitis media include:
- severe earache
- a feeling of 'fullness' in the ear
- ringing in the ear
- a discharge of blood and pus if the ear drum ruptures
- feeling generally unwell, with nausea, vomiting
- children tugging at the ear or having trouble
swallowing their food
Chronic otitis media
The symptoms of chronic otitis media are much less severe than
with acute otitis media. It is usually painless, but there is
likely to be a discharge of thick, smelly pus, and hearing may
There are no obvious signs of glue ear. Children sometimes complain
that their ear feels 'plugged up' but the main symptom is deafness,
which, in small children, is often mistaken for lack of attention.
|To diagnose otitis media,
the doctor may:
- look into the ears with an instrument called an
- take a sample of any discharge for laboratory
- take a sample of blood for testing to confirm
the presence of infection
- carry out some simple hearing tests
- request head X-rays or a CT scan to discover whether
the infection has spread from the middle ear
|Left untreated, acute and
chronic otitis media can lead to deafness or other serious complications.
Glue ear rarely causes long-term physical damage, but the temporary
deafness can affect a child's educational and social development.
For these reasons, it's important to see a doctor if you think
your child has otitis media.
Acute otitis media is often given a chance to clear up on its
own. If this does not happen, it may be treated with antibiotics.
Sometimes, nasal drops or sprays are prescribed to help unblock
the Eustachian tube. Eardrops or tablets may be prescribed for
If the eardrum is likely to burst, a specialist in ear, nose and
throat problems may perform a procedure called a myringotomy.
This involves making a tiny hole in the eardrum (under general
anaesthetic) so the fluid can drain out. The eardrum should heal
about a week after the infection has cleared.
Chronic otitis media may be treated with antibiotics to clear
the infection. However, surgery provides a more permanent solution.
An operation called a tympanoplasty can repair the perforated
eardrum, as well as any damage done to the bones in the middle
ear. Alternatively, if the condition is caused by cholesteatoma,
the excess tissue can be surgically removed.
Glue ear may clear up without treatment, but may also be treated
with antibiotics. When hearing loss is involved, some doctors
recommend a tympanostomy - an operation in which a tiny hole is
made in the eardrum and a tube called a grommet is inserted. This
allows lets the ear drain continually, and usually restores hearing.
If a child does have a grommet, an earplug must be used when swimming
to prevent bacteria entering the ear. He or she should also be
examined regularly by a doctor. The grommet usually falls out
after eight months to a year, and the hole usually closes within
another eight to nine months.
Not all doctors recommend grommets. The risks include permanent
damage to the middle ear or eardrum.
|Preventing otitis media
|Good management of colds,
flu and sore throats, and of hay fever and other allergies may
help. There is some evidence that breastfeeding babies during
their first three months, and that feeding babies in an upright
position, decreases the risk of glue ear. Passive smoking and
using a dummy have been shown to increase the risk.
|Royal National Institute
for Deaf People
American Academy of Otolaryngology - Head and Neck Surgery
National Institute on Deafness and Other Communication Disorders
|Healthwise (Health Information Resource
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