Otitis Media

Also known as: middle ear infection, acute otitis media, AOM.

What is otitis media?

When the space behind the eardrum or middle ear (where the tiny bones pick up the vibrations of speech and relay them onto the inner ear for transmission to the brain for interpretation), gets infected, it’s known as otitis media. The middle ear is connected to the back of the throat (nasopharynx) by a tube called the Eustachian tube which allows for equalization of the pressure, (and keeps the air fresh), between the middle ear and outside. When a single episode of infection occurs it’s called acute otitis media. If it happens more often it’s called recurrent otitis media. If fluid collects in the middle ear is known as acute otitis media with effusion. If fluid remains in the middle ear for a long time or recurs even without infection it’s called chronic otitis media with effusion. Otitis media often affects children with 5 out of 6 children having at least one ear infection by the age of 3 years.

What causes otitis media?

Otitis media usually occurs when there is a blockage of the soft Eustachian tube. The air there becomes stagnant and damp allowing for germs to multiply causing an infection. Blockage can occur after a viral or bacterial infection of the nasopharynx, with allergies, sinus infections or enlargement of the adenoids for other reasons. Risk factors include a family history of ear infections, prematurity, bottle feeding, use of a pacifier, prone sleeping position, children who attend daycare centers, a tobacco smoke environment, and children with abnormalities of the mouth or immune system.

What are the symptoms of otitis media?

In the newborn difficulty with feeds may be the only symptom. In older infants/children, in addition to complaining of ear pain, tugging on the ear, fluid drainage from the ear, fever, irritability, poor sleep and restlessness/fussiness, vomiting, diarrhea, hearing loss, headache are common symptoms.

What are otitis media care options?

Antibiotics may be used for a bacterial infection though typically the cause is a viral infection that requires symptom treatment such as over-the-counter pain relievers (acetaminophen), ear drops or applying a warm washcloth to the ear. Depending on a number of factors needle drainage of an effusion through the eardrum, or the surgical placement of ventilating tubes into the eardrum may be undertaken. If otitis media is persistent or occurs frequently, removal of the adenoids may be recommended.

Reviewed by: Jack Wolfsdorf, MD, FAAP

This page was last updated on: October 03, 2019 03:44 PM