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| Inflammation of the middle ear (otitis media) |
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Written by Dr Robert Mills, consultant otolaryngologist
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What is inflammation of the middle ear?
Inflammation of the middle ear is an infection caused by a germ
(bacterium). It is
very common among children. The middle ear is an air-filled hollow between the
eardrum and the inner ear.
The Eustachian tube - an air channel between the middle ear and
the nose - usually ensures that the middle ear is ventilated and that fluids
can run out through the nose.
Middle ear infection most commonly occurs following a
cold. It also
frequently occurs as a result of contact with other children.
What causes inflammation of the middle ear?
The infection spreads through the Eustachian tube to the middle
ear. The risk of contracting an infection is higher if the Eustachian tube is
small or does not work efficiently, which is often the case with small
children.
Ear infections may also be caused by childhood illnesses, such
as
measles.
What are the symptoms of an inflammation of the middle
ear?
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The ear is very painful.
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Hearing is reduced.
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The child feels unwell.
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High
temperature.
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If the eardrum bursts, there may be discharge (fluid) from the
ear.
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Good advice
Avoid smoking in the
home, because smoke increases the risk of middle ear infection in children.
If small children have had several middle ear infections, find
out if this has affected their hearing.
Mothers shouldn't breastfeed their child while lying
flat.
Paracetamol (eg Calpol) will
help relieve the
earache.
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How is the diagnosis made?
The diagnosis can usually be made on the basis of the symptoms
and by examining the ear with an
otoscope.
Possible complications
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Infections may spread to the bone behind the ear, although this
is uncommon.
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In rare cases,
meningitis or a
temporary facial numbing may develop.
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The reduction of hearing is usually only temporary, but if
cases of inflammation are recurrent it may become chronic and result in delayed
language development.
A middle ear infection can usually be treated by your GP.
However, if there is persistent hearing loss a specialist should be
consulted.
How is ear inflammation of the middle ear treated?
Pain relief
Mild pain relievers such as
Paracetamol (eg Calpol) or ibuprofen (eg Nurofen for children)
can be
helpful, especially for children, because the pain can be quite severe.
Nose drops
Nose drops containing decongestants that can be bought over the counter will reduce the
swelling of the mucous membranes lining the nose and the back of the throat.
In theory, the drops allow the Eustachian tubes, which drain the middle
ear, to remain open.
Unblocking these tubes will release pressure in the middle ear
and so relieve the pain.
Antibiotics
A doctor may sometimes prescribe a course of
antibiotics if the inflammation is
thought to be caused by bacteria.
It is often difficult to distinguish between
bacterial and viral
infections. In most cases of middle ear infection, antibiotics have been shown
to be of little benefit.
Repeated inflammation
In cases of repeated inflammation, a drainage tube known as a
grommet can be placed in the eardrum to drain and ventilate the middle ear.
This is more commonly done in children, but only if they have
repeated attacks or their hearing is impaired.
The common name for a build-up of fluid in the middle ear that
is not due to an infection is called
glue ear.
If children frequently suffer from ear inflammation caused by
enlarged
adenoids or
tonsils, they may be
removed surgically.
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Last updated 02.06.2005
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