An infection of the middle ear, also known as otitis media, is the most common of the three types of ear infections. This condition mainly affects young children, but it is possible for adults to develop a middle ear infection in rare cases. The middle ear is the part of the ear that is composed of the inner end of the ear canal, the eardrum or tympanic membrane, and the small bones that help to conduct sounds to the inner ear. Tubes called the eustachian tubes that drain from the middle ear have an opening behind the eardrum. The eustachian tubes are longer and bigger in adults, so they are less likely to get blocked off than the eustachian tubes of children; this explains the discrepancy in who is more likely to suffer from otitis media.
In a middle ear infection, the eustachian tubes get inflamed and drainage of fluid from the middle ear gets blocked, so pressure builds up behind the eardrum, causing a painful earache. In most cases of acute middle ear infections, a child will have an upper respiratory infection, like the common cold, before the onset of the ear infection. Inflammation will occur in the middle ear and once the fluid starts to build up, a secondary bacterial infection occurs, making the infection worse and more painful. Some children have problems with chronic or repeated middle ear infections.
Symptoms of a middle ear infection include pain inside the ear, fever, crying and irritability, hearing loss in the affected ear, fluid draining from or crusting in the ear, balance problems, sleep problems and appetite suppression. Really young children especially may also have symptoms such as upset stomach, vomiting and diarrhea with a middle ear infection. Young children may ‘pull’ at the ear indicating ear pain. In severe cases, fluid that builds up behind the eardrum can cause the eardrum to rupture; this normally heals on its own. In the case of a ruptured eardrum, the pressure is relieved from behind the eardrum so the pain may decrease after it happens, and fluid and pus may drain out of the ear suddenly.
Treatment for a middle ear infection depends on the severity of the infection and the age of the child. Mild cases normally clear up on their own after a couple of days, so children over the age of 6 months who have mild symptoms and are not sick with any other condition may not receive antibiotics. It may be recommended that the child take over-the-counter pain relieving medication such as Tylenol, and in some cases prescription ear drops may be given. Antibiotics may be given for infants, children with severe ear pain and children with a high fever with their otitis media. If a child has recurring or chronic ear infections, a doctor may want to surgically place small tubes in the middle ear through the eardrum so that fluid can drain from the middle ear and the frequency of ear infections decreases. This is an outpatient surgery, and the results usually last for about six months to a year.