Ear Infections Overview

Ear infections, medically known as otitis media, are among the most common medical issues in childhood. They are the leading reason for doctor visits in children, with about three out of four children in the United States experiencing at least one ear infection by age three.

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Causes of Ear Infections

Ear infections can affect any part of the ear but most often occur in the middle ear. They develop when fluid accumulates behind the eardrum in the Eustachian tubes—the narrow passages connecting the ears to the nose. This trapped fluid creates a moist environment that encourages the rapid growth of bacteria, leading to infection. While bacteria are the usual cause, viruses or allergies can sometimes trigger ear infections.

Children are more prone to ear infections because their Eustachian tubes are shorter and narrower compared to adults. Consequently, ear infections are less common in adults.

Risk Factors for Ear Infections

Several factors can increase the likelihood of ear infections, including:

  • Genetic or anatomical predisposition
  • Bottle feeding position (bottle-fed babies are more prone than breastfed infants)
  • Attendance at group child care settings (higher exposure to sick children)
  • Exposure to secondhand smoke
  • Weakened immune system
  • Allergies
  • Use of pacifiers

Symptoms of Ear Infections

Common signs and symptoms may include:

  • Ear pain
  • Fever
  • Headache
  • Difficulty hearing
  • Ear discharge
  • Dizziness or balance problems
  • Loss of appetite or vomiting
  • Feeling of fullness or popping in the ears

Young children who cannot speak may show symptoms such as ear pulling, frequent crying, irritability, and trouble sleeping, especially during or following a cold.

Diagnosis of Ear Infections

Doctors diagnose ear infections with a physical exam using an otoscope, a small lighted instrument to examine the eardrum. Hearing tests may also be conducted to assess any hearing loss, especially in cases of recurrent infections.

After an infection, patients are checked for otitis media with effusion, a condition where fluid remains trapped behind the eardrum. Although it may not cause symptoms, this condition requires treatment to avoid complications.

Treatment of Ear Infections

Treatment focuses primarily on relieving pain and reducing congestion with oral medications or ear drops, as most ear infections resolve on their own within two to three days. Antibiotics are prescribed only if the infection is bacterial, as viral infections do not respond to these medications.

For severe or persistent infections, doctors may recommend corticosteroids or surgically placing ear tubes to help drain fluid. If repeated infections stem from anatomical issues, additional surgical procedures may be necessary.