Ear infections, known as otitis media, are usually caused by a bacterial or viral infection in the middle ear. The middle ear is the air-filled space behind the eardrum.
There are three main types of ear infections: acute otitis media (AOM), otitis media with effusion (OME) and chronic otitis media with effusion (COME). AOM is the most common type of ear infection and usually includes an earache caused by fluid trapped in a swollen ear. A fever may also accompany AOM. OME occurs after an ear infection has run its course but fluid has remained trapped in the middle ear. COME happens when fluid either remains in the ear for an extended period of time or becomes frequently trapped in the ear, even if there isn’t an infection.
Ear infections usually occur after another illness, such as a cold or the flu. These often lead to congestion and swelling in the nasal passages, throat and the Eustachian tubes. The Eustachian tubes, a pair of narrow tubes connecting the middle ear to the back of the throat, are responsible for regulating air pressure and drainage from the middle ear. If these tubes become inflamed fluids will remain in the ear.
In order to diagnose an ear infection, your doctor will review your medical history and look into your ear with a lighted tool. Your doctor will then use a pneumatic otoscope, which pushes a puff of air into the ear canal to check for a buildup of fluid. If your doctor is still unsure whether there is liquid trapped in the middle ear, a tympanometry test is performed to measure the air pressure within the ear.
If you are not experiencing severe ear pain and don’t have a fever, your doctor may suggest the “wait-and-see” approach. This would simply involve waiting a few days to see if the symptoms go away on their own. Most ear infections will clear within one to two weeks. If the ear infection does not go away or the symptoms get worse, antibiotics will be prescribed to treat the infection. Chronic ear infections, defined as more than four episodes in a year, may require additional intervention in the form of ear tubes. Ear tubes are surgically implanted through a hole made in the eardrum into the middle ear to help with drainage.
While ear infections can affect individuals of any age, they are more common in children. One reason for this is that the Eustachian tubes of children are narrower, which means they are more easily clogged. Another reason is because of the adenoids. Adenoids are small pads of tissues located at the back of the throat near the opening of the Eustachian tubes. In children, they can easily become inflamed or enlarged due to infection. Inflamed adenoids will block the Eustachian tubes.