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Inner/Middle Ear Problems

An ear infection (acute otitis media) is a common ailment that frequently affects children but can also afflict adults. It is most often a bacterial or viral infection that affects the middle ear, the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear. This infection often results from another illness, such as a cold, flu, or allergy that causes congestion and swelling of the nasal passages, throat, and Eustachian tubes, the tubes that run from each middle ear to high in the back of the throat, behind the nasal passages.

Swelling, inflammation, and mucus in the Eustachian tubes from an upper respiratory infection or allergy can block the tubes, causing the accumulation of fluids in the middle ear. A bacterial or viral infection of this fluid is usually what produces the symptoms of an ear infection. Ear infections are more common in children, in part, because their Eustachian tubes are narrower and more horizontal — factors that make them more difficult to drain. Children also tend to have larger adenoids which could block the tubes and prevent drainage.

Symptoms of ear infections usually improve within the first couple of days, and most infections clear up on their own within one to two weeks without any treatment. The American Academy of Pediatrics and the American Academy of Family Physicians recommend a wait-and-see approach as one option for children over the age of 6 months with mild inner ear pain in one ear for less than 48 hours and a temperature less than 102.2 F. Some evidence suggests that treatment with antibiotics might be beneficial for certain children with ear infections. Talk to your doctor about the benefits of antibiotics weighed against the potential side effects and concern about overuse of antibiotics creating strains of resistant disease.

Our ENT specialists can advise you on treatments to lessen pain from an ear infection. These may include a warm compress or over-the-counter pain medication. Use the medications as directed on the label. Use caution when giving aspirin to children or teenagers. Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin because aspirin has been linked with Reye's syndrome. Talk to your doctor if you have concerns.

After an initial observation period, your doctor may recommend antibiotic treatment in some cases. Even after symptoms have improved, be sure to use the entire antibiotic as directed. Failing to do so can result in a recurring infection and resistance to the antibiotics. Talk to your doctor or pharmacist about what to do if you accidentally skip a dose.

If your child has recurrent otitis media or otitis media with effusion, our specialists may recommend a procedure to drain fluid from the middle ear. Otitis media is defined as three episodes of infection in six months or four episodes of infection in a year with at least one occurring in the past six months. Otitis media with effusion is a persistent fluid buildup in the ear after an infection has cleared up or in the absence of any infection.