Otitis media: symptoms and treatment

How does a middle ear infection occur?

The middle ear is the part of the ear that lies at the end of the ear canal behind the eardrum. The middle ear is connected to the nasopharynx via the so-called ear trumpet, also known as the tube, so that it can be adequately ventilated. However, pathogens can also get into the middle ear via this auditory tube and trigger an acute middle ear infection, a so-called otitis media.

Why do children in particular get middle ear infections?

It is mostly children who are affected by a middle ear infection. A middle ear infection occurs in most cases between the 6th and 18th month of life. By the age of 6, an estimated two-thirds of all children will suffer from a middle ear infection at least once. After that, a middle ear infection is generally less common.

Otitis media is so common in young children because the auditory tube is shorter and wider than in adults. This makes it easier for pathogens to penetrate the middle ear from the nasopharynx and ultimately lead to inflammation of the mucous membrane and possible fluid formation, the so-called tympanic effusion, in the middle ear. In addition, an enlargement of the pharyngeal tonsils (also adenoids or polyps), which is not uncommon in small children, as well as passive smoking and the associated weakening of the immune system, but also allergies can increase the risk of middle ear infections in children.

Causes of otitis media

A middle ear infection is often caused by a viral infection, such as a cold, flu, or measles . The viruses multiply in the nasopharynx and in the auditory tube and thus cause an additional bacterial infection. In many cases, for example in the case of enlarged tonsils, bacteria are the trigger of a middle ear infection from the outset.

Middle ear infection symptoms

Typical symptoms of a middle ear infection are:

• throbbing, stabbing earache
• ear pressure
• limited hearing
• general feeling of illness, such as nausea, diarrhea or dizziness
• Running in the ears: bloody or purulent discharge comes out when the eardrum has already ruptured. The pain subsides immediately.

Babies and toddlers usually have the following additional symptoms:

• Fever
• general unrest
• keep touching your ears
• cry a lot
• drink little

Many middle ear infections go away without consequences with appropriate treatment. A ruptured eardrum usually closes itself again within a few days. In rare cases, however, complications can also occur. A middle ear infection can spread and lead to inflammation of neighboring cavities of the so-called bony mastoid (mastoid) and, in the worst case, to meningitis. If middle ear infections occur more frequently, consequential damage such as hearing loss or chronic middle ear infections can also occur.

It is therefore definitely advisable to consult a doctor if you recognize symptoms of a middle ear infection in your child or in yourself. Because a doctor, if possible an ear, nose and throat doctor, can best and most reliably assess whether and which treatment measures should be initiated to cure the middle ear infection.

Diagnosis, treatment and duration of otitis media

Treatment for a middle ear infection by a doctor depends on the stage and degree of inflammation. To diagnose a middle ear infection, the doctor first clarifies symptoms and possible previous illnesses, such as a cold. In addition to the examination of the eardrum, other examinations such as hearing tests, balance tests or blood counts are used in some cases.

The main options for treating a middle ear infection are as follows:

• Decongestant nasal sprays or nose drops are used especially when a middle ear infection begins. The remedies ensure that the swelling of the mucous membranes and the auditory tube decreases and that sufficient air gets into the middle ear again.
• In addition, doctors often recommend anti-inflammatory and painkilling tablets with active ingredients such as ibuprofen or paracetamol for children.
• If there is no leaking ear that indicates a tear in the eardrum, the doctor can also prescribe ear drops to relieve pain.
• Antibiotics are often used in middle ear infections to reduce the risk of complications or consequential damage such as hearing loss. The treatment of a middle ear infection with antibiotics should only be carried out if the measures already described are not effective enough. Decisive for the administration of antibiotics are usually the previous course of the disease and possible previous and secondary diseases.
• The tympanic effusion, i.e. the accumulation of fluid behind the eardrum, can persist for weeks after the middle ear infection. If it does and it doesn’t rupture on its own, the eardrum can be opened surgically and the pressure relieved. Since the eardrum normally closes by itself after a few days, the doctor often inserts a so-called tympanostomy tube into the opened eardrum. This ensures that the liquid can continue to drain. The tympanostomy tube is removed after six to twelve months if it has not already shed itself.
• It is advisable to have enlarged tonsils removed, especially for children who often struggle with middle ear infections.

After starting treatment, you should see an improvement in about two days. Another check-up appointment with the doctor after about two weeks makes sense. In this way it can also be ensured that a possible tympanic effusion has receded.

Preventing a middle ear infection?

A healthy, smoke-free lifestyle with a balanced diet and physical activity is the best support for a well-functioning immune system and thus a strong defense against viral infections and middle ear infections. If a middle ear infection does occur, it can usually be treated well. It is important that you pay attention to possible warning signs and consult a doctor in good time.