Inflammation of the middle ear (otitis media)

Written by Dr Robert Mills, consultant otolaryngologist

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?

The ear is very painful.

Hearing is reduced.

The child feels unwell.

High temperature.

If the eardrum bursts, there may be discharge (fluid) from the ear.

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 will help relieve the earache.

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

Infections may spread to the bone behind the ear, although this is uncommon.

In rare cases, meningitis or a temporary facial numbing may develop.

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 or ibuprofen can be helpful, especially for children, because the pain can be quite severe.

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