What are ear infections?
There are 2 types of ear infections. Otitis media is an infection of the middle ear that may cause a change in the eardrum, such as swelling or redness. Otitis externa is an ear infection of the external ear canal and is commonly called “swimmer’s ear”. This handout discusses Otitis media, or middle ear infection.

What causes ear infections? 
Collection of fluid behind the ear drum often develops after viral upper respiratory infections or due to seasonal allergies.  Inflammation in the draining tube of the ear (the Eustachian tube) blocks drainage of this fluid and bacteria can contaminate the area.  Fluid and/or pus fill the area and pushes on the ear drum from the inside.  This causes pain and a temporary hearing loss.  Occasionally the ear drum will rupture and pus will leak.

Children are prone to ear infections, when the Eustachian tubes do not work properly (due to colds allergies, enlarged adenoids, or not being in a favorable angle. This results in a build of negative pressure (a vacuum effect) in the middle ear and causes the eardrum to be sucked inward; this is a retraction of the eardrum. This predisposes the child to developing an ear infection and/or fluid buildup.


What are the symptoms of an ear infection?

  • Ear pain
  • Babies may pull, scratch, touch, or stick fingers in their ears.
  • Irritability
  • Fever
  • Drainage from the ear (if the ear drum has ruptured)
  • Hearing loss in the affected ear
  • Loss of balance
  • Nausea/Vomiting
  • Diarrhea
  • Dizziness or Clumsiness

The presence of fluid in the middle ear is called an effusion. A child with fluid, who has ear pain and fever, usually has an ear infection and should have an antibiotic prescribed. This helps the body remove bacteria in the fluid. The antibiotic decreases the chance infection will spread from the ear to the other areas of the body. Fluid in the middle ear interferes with hearing, so the purpose of treatment is to remove the infection and the fluid. Until all the fluid is gone, the child will probably not have normal hearing.

Untreated ear infections may lead to:

  • Chronic ear infection
  • Mastoiditis- infection in the bone around the ear
  • Cholesteatoma- a growth in the middle ear that can permanently affect hearing
  • Meningitis

You and your doctor may also be concerned with the number of ear infections your child is having, even if treatment is successful and the fluid disappears each time. Young children commonly have several ear infections a year, often in the winter months. For the child with repeated ear infections and/or fluid buildup, Myringotomy tubes (a.k.a.-ear tubes, pressure equalization or PE tubes) may be the treatment of choice. They are small plastic tubes placed surgically in the eardrum by an ENT. The child is placed under anesthesia or deep sedation and the tube is placed in the ear drum. This allows for drainage of fluid from the middle ear with the goal of reducing the incidence of further ear infections. The placement of PE-tubes is often very effective in decreasing the need for antibiotics, in improving hearing, and in decreasing the potential for speech problems in children with chronic recurrent ear infections. PE-tubes placement is a relatively short and simple surgery.