The middle ear is the space behind the eardrum and is responsible for transmission of sound from the outer to the inner ear. Infection of the middle ear can be acute or chronic.
Acute Otitis Media refers to fluid in the middle ear with signs and symptoms of infection such as pain, fever, bulging eardrum and hearing loss.
It is impossible to prevent middle ear infection totally. However, some useful measures include:
a. Discourage the use of pacifiers
as this predisposes the child to
middle ear infection. Also avoid
letting the child drink while lying
flat on his back.
b. Wash hands and clean toys
frequently as the viruses that
cause upper respiratory tract
infections (flu/cold) can be
transmitted by contact.
c. Avoid being in a small room with
other sick children or adults as
respiratory tract infections can
also be spread through the air.
d. Breastfeeding is very useful
in reducing the number of
ear infections. A child should
be nursed throughout the
first year. Even a few weeks of
breastfeeding can result in fewer
e. Vaccinate your child with the
pneumococcal and flu vaccines
as they help in the prevention of
f. Treat your child for allergies
and avoid exposure to cigarette
g. Ensure that the child gets
sufficient sleep and good
The middle ear is connected to the back of the nose via a small canal called the eustachian tube. Bacteria can make their way into the middle ear via this canal where they are usually flushed out through the eustachian tube. Both bacteria and virus can infect the middle ear.
A blockage in the canal (usually due to a cold/flu), or when it does not function properly, can lead to germs getting trapped in the middle ear, causing an ear infection.
Children are predisposed to suffer from acute otitis media because of the anatomy and function of their ears and eustachian tube.
Children are prone to ear infections
because their eustachian canal is
smaller and more horizontal. They tend
to get more ear infections between
6 to 24 months. They are also more
prone to upper respiratory tract
infections such as colds and flus.
An ear infection, in itself, is not
contagious but the upper respiratory
viruses that cause the infection can
spread amongst children. Therefore,
children in day care are more prone
to ear infections. Children who use
pacifiers are also at risk.
Other risks factors include immature
immune systems and factors that
can cause the eustachian canal to be
blocked are allergies, acid reflux, or
environmental irritants like tobacco
Most middle ear infections will resolve on their own, without antibiotics. A healthy, older child may be treated with pain killers and close followup.
Antibiotics can be given if the symptoms are severe, persist, or worsen. Antibiotics may also be given to children who are young or at risk for complications to help resolve the infection, reduce pain and prevent complications. Once antibiotics are given, the fever and pain should improve or resolve within 48 to 72 hours.
Painless fluid in the middle ear may last for a few weeks or months after an acute infection. It may be necessary to drain the fluid if it fails to drain by itself.
Symptomatic relief of upper respiratory infection symptoms (running nose, blocked nose) with antihistamines or nasal decongestants may be given.
Complications such as acute mastoiditis, meningitis and brain abscess arising from middle ear infection are now rare because of antibiotics usage.