Related Health Information
Acute Otitis Media (Middle Ear Infection)
What is acute otitis media (AOM)?
Acute otitis media is infection of the middle ear by a bacteria and/or virus. Acute otitis media can occur as a result of a cold, sore throat or respiratory infection.
Facts about acute otitis media
- About 75 percent of children have at least one episode of acute otitis media by the time they are 3 years of age.
- Nearly half of these children have three or more episodes by the time they are 3 years of age.
- Acute otitis media can also affect adults, although it is primarily a condition that occurs in children.
- Acute otitis media is the most common diagnosis for children in the U.S.
- About 30 million visits to the pediatrician each year are a result of acute otitis media.
- Acute 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.
- Acute otitis media is more common in boys than girls.
- Acute otitis media occurs more often in the winter and early spring.
Who is at risk for getting ear infections?
While any child may develop an ear infection, the following are some of the factors that may increase your child's risk of developing ear infections:
- Having a cold
- Spending time in a day care setting
- A poor immune system
- Being bottlefed while lying on the back
- Being around someone who smokes
- Absence of breastfeeding
- Family history of ear infections
- Craniofacial Abnormalities (e.g. cleft palate)
What causes acute otitis media?
Middle ear infections are usually a result of poor function of the eustachian tube, the canal that links the middle ear with the throat area. The eustachian tube helps to equalize the pressure between the air around you and the middle ear.
When this tube is not working properly, it prevents normal drainage of fluid from the middle ear, causing a build up of fluid 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:
- Immature eustachian tube (common in young children)
- Inflammation of Adenoids
- A cold or allergy, which can lead to swelling and congestion of the lining of the nose, throat and eustachian tube (this swelling prevents the normal flow of air and fluids)
- A malformation of the eustachian tube
What are the symptoms of otitis media?
The following are the most common symptoms of otitis media. However, each child may experience symptoms differently. Symptoms may include:
- Ear pain
- Tugging or pulling at one or both ears
- Fever
- Hearing difficulties
- Difficulty sleeping or staying asleep
- Unusual irritability
- Fluid draining from ear(s)
- Loss of balance
- Nausea and vomiting
- Diarrhea
- Decreased appetite
- Congestion
The symptoms of acute otitis media may resemble other conditions or medical problems. Always see your child's physician for a diagnosis.
How is acute otitis media diagnosed?
In addition to a complete medical history and physical examination, your child's physician will inspect the outer ear(s) and eardrum(s) using an otoscope. The otoscope is a lighted instrument that allows the physician to see inside the ear. A pneumatic otoscope blows a puff of air into the ear to test eardrum movement.
A hearing test may be obtained in children who have frequent ear infections.
Treatment for acute otitis media
The specific treatment for this condition depends on many factors and is tailored for each child. Please discuss your child's condition, treatment options and your preferences with your child's physician or healthcare provider.
Treatment may include:
- Antibiotic medication by mouth (if a bacteria is suspected)
- Medication (for pain)
- Ear drops in select cases where drainage is present
If your child continues to have frequent ear infections, your child's physician may suggest that ear tubes (myringotomy 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 allow air to enter (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 six to 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 the nasopharynx) if they are infected. Removal of the adenoids has been shown to help some children with acute otitis media.
Treatment will depend upon the type of otitis media. Consult your child's physician regarding treatment options.
What are the effects of acute otitis media?
In addition to the symptoms listed above, acute otitis media can also result in any or all of the following:
- Serous otitis media (otitis media with effusion)
- Problems with speech and language development
- Infection in other parts of the head such as the mastoid or the brain (Mastoiditis)
- Permanent hearing loss (rarely)
For more information, refer to the following resources from AAO-NHS:
Reviewed by: Steven D. Handler, MD, MBE
Date: April 2009
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