Otitis media (middle ear infection)

What is otitis media (OM)?

Otitis media is inflammation located in the middle ear. The middle ear is the space behind the eardrum. Otitis media can occur as a result of a cold, sore throat, or respiratory infection.

Facts about otitis media:

  • Otitis media occurs most often in children younger than 7 years of age and even more frequently in children between the ages of 6 months and 3 years.
  • Otitis media is more common in boys than girls.

Who is at risk for getting ear infections?


  • Spends time in a daycare setting.
  • Being around someone who smokes.
  • Family history of ear infections.
  • A poor immune system.
  • Absence of breastfeeding.
  • Having a cold.
  • Bottlefed while laying on the back.

What causes otitis media?

Middle ear infections are usually a result of a poorly functioning eustachian tube, a canal that links the middle ear with the throat area. When this tube is working properly it:

  1. Allows air to ventilate into the middle ear.
  2. Allows drainage of fluid out of the middle ear.
  3. Protects the middle ear from bacteria and viruses.

When the eustachian tube in not functioning properly bacteria and viruses are more likely to grow in the middle ear and lead to acute otitis media. Fluid is more likely to build up behind the eardrum. When this fluid cannot drain, it allows for the growth of bacteria and viruses in the ear that can lead to acute otitis media. The following are some of the reasons that the eustachian tube may not work properly:

  • A malformation of the eustachian tube.

What are the different types of otitis media?

Different types of otitis media include the following:

  • Acute otitis media (AOM) - the middle ear infection occurs abruptly causing swelling and redness. Fluid and mucus become trapped inside the ear, causing the child to have a fever, ear pain and hearing loss.

What are the symptoms of otitis media?


  • 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.
  • Ear pain.
  • Nausea and vomiting.
  • Diarrhea.
  • Decreased appetite.
  • Congestion.


How is otitis media diagnosed?


If fluid remains in the ear(s) for longer than three months, or your child has repeated ear infections, your child's physician may suggest that small tubes be placed in the ear(s). This surgical procedure, called myringotomy, involves making a small opening in the eardrum to drain the fluid and relieve the pressure from the middle ear. A small tube is placed in the opening of the eardrum to ventilate the middle ear and to prevent fluid from accumulating. The child's hearing is restored after the fluid is drained. The tubes usually fall out on their own after about twelve months.

Your child's surgeon may also recommend the removal of the adenoids (lymph tissue located in the space above the soft roof of the mouth, also called nasopharynx). Removal of the adenoids has shown to help some children with otitis media.

What are the effects of otitis media?


  • Infection in other parts of the head.
  • Permanent hearing loss.
  • Problems with speech and language development.

Antibiotic overuse


Overuse of antibiotics is leading to strains of diseases that are becoming resistant to the medication, making it harder to treat patients. All too often, antibiotics have been prescribed for conditions such as colds, fluid in the middle ear or bronchitis, which do not respond to antibiotics, according to the Centers for Disease Control and Prevention (CDC). Antibiotics are only effective in treating bacterial infections.


  • Take the antibiotics as prescribed.
  • Finish the full course of antibiotics, as prescribed.
  • Do not save or reuse antibiotics.

Always consult your child's physician for more information.