Ear Infections (Otitis Media)

An ear infection, or otitis media, is a bacterial or viral infection that affects the middle ear. This condition impacts both adults and children. However, it is much more common in childhood, and statistics show that about two-thirds of children under the age of 3 years will have at least one ear infection. 

Otitis media can be acute or chronic. The former is an ear infection that develops suddenly, leading to swelling, redness, fever, pain, and irritability. However, chronic ear infections may occur repeatedly or not clear up quickly. Sometimes, a chronic ear infection in adults can cause permanent ear damage. 

Pathophysiology and Risk Factors

Generally, otitis media develops due to the presence of a virus or bacteria in the middle ear. A fungal ear infection may also occur in some cases. Other illnesses may also predispose a person to an ear infection, including the common cold, allergies, or the flu. These cause swelling and congestion of the throat, nasal passages, and the Eustachian tubes. 

When the eustachian tubes become swollen, whether this is due to infection of the middle ear or another condition, fluids can build up in the middle ear. This presents as the symptoms of pain and swelling often associated with ear infections.

This condition is more common in kids due to narrower Eustachian tubes, which hinder fluid from draining. Adenoids also play a significant role in otitis media. These tissues are present at the back of the nose and are involved in the activity of the immune system. Located near the openings of the Eustachian tubes, swelling of these tissues can block the tubes, increasing the chance for infection. The adenoids of children are relatively larger than those of adults. Therefore, they play a more significant role in ear infections in children. 

Common risk factors for the development of otitis media are: 

• Age – The size of adenoids and eustachian tubes predisposes children between 6 months and two years to ear infections. Ongoing development of the immune system during childhood is a further contributing factor. 
• Seasonal factors – Winter and fall seasons put people at risk of ear infections. During these seasons, pollen counts are high, affecting people with seasonal allergies. Tendency to stay indoors also aids in the spread of pathogens. 
• Poor air quality – High levels of air pollution and exposure to smoke increase the risks of otitis media. 
• Cleft palate – children with cleft palates often have different bone and muscle structures. Thus, their eustachian tubes may not drain well. 

Ear infections usually present with local pain and discomfort. These symptoms may persist or occur intermittently. Also, they may affect one ear or both ears. Sometimes, the symptoms of chronic otitis media may be less noticeable. Symptoms of an ear infection include:

• Ear pain and discomfort
• Pus-like drainage from the ear(s)
• A feeling of pressure inside the ear(s)
• Fever
• Pain in other areas of the face such as the jaw or a general headache 
• Loss of appetite 
• Fussiness in infants 
• Temporary hearing loss 

If you are experiencing one or more of the above symptoms, talk to one of our online doctors now for immediate relief.

Diagnosing an ear infection usually involves the examination of the ears using an otoscope. This is a lighted tool with a magnifying lens that helps your doctor see into your ear canal. A visual exam of your middle and inner ear may reveal one or a combination of the following: 

• Redness, pus-like fluid, or air bubbles in the middle ear 
• Perforation of the eardrum 
• Collapsed or bulging eardrum 
• Draining fluid from the middle ear 

An advanced infection may require your physician to take samples of the fluid in your ear. They will then test the sample to determine what pathogen is the cause of your infection to treat it effectively. 

In more complex cases, your doctor may want to use imaging like a computed tomography (CT) scan to check if the infection has surpassed beyond the middle ear. Chronic ear infections may also require a hearing test. 

If you are suffering from this uncomfortable condition, you may be wondering, do ear infections go away? Some cases of mild otitis media can clear up without treatment. However, the following at-home treatments can help relieve symptoms: 

• Acetaminophen - This pain reliever decreases fever and pain caused by an ear infection. It is a common over-the-counter (OTC) medicine. However, you must be careful not to take too much and follow the instructions for use carefully.
• NSAIDs - This is another group of pain relievers that can reduce discomfort and swelling of the ear. A common one is ibuprofen, and you can get it without a doctor’s prescription. It will be best to take this medicine with food and ask your doctor if you have any questions or would like to administer this to your child.
• Ear drops - Some OTC and ear drops may help relieve discomfort.
• Heat - Applying a warm compress to your ear can ease discomfort and help to facilitate drainage.

If your symptoms persist despite trying the above remedies, your doctor can prescribe an appropriate medication to resolve your infection. This is usually an antibiotic in the form of ear drops or oral tablets, or capsules. 

If there is no noticeable improvement with medication, minor surgery may be an option. This may also be the case if you suffer from recurrent ear infections over a short period. Ear, nose, and throat surgeons can insert ear tubes to help allow fluid drainage. They can also remove enlarged adenoids if they are contributing to your infections.

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An ear infection may clear up without intervention. However, it may recur, and there is a potential for complications to develop. Temporary or mild hearing loss may occur repeatedly. If left untreated, hearing loss may worsen and can lead to permanent damage to the eardrum. 

Another potential issue that can arise from an untreated ear infection or one that does not respond to therapy is the spread of the infection to nearby tissues. Thus, there is a possibility of the emergence of mastoiditis (a bony protrusion) of the ear. Other complications include developmental delays and tearing of the eardrum. 

Usually, prompt and adequate treatment eliminates the potential for complications. With prescription medication, most people report symptom improvement in a few days. Taking proper preventive measures also reduces your risk for recurrent ear infections.

If you suspect you or your child may be suffering from ear infection symptoms, see one of our online doctors now. By taking this step, you can get on the road to recovery and prevent potential complications.