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Ear Infection (Acute Otitis Media)

ABCMD definition of Ear Infection (Acute Otitis Media): An infection (bacteria) of the portion of your ear just past your eardrum.

What is an Ear infection?:
There are actually 3 types of infections you can be diagnosed within your ear. The first is the classic “ear infection,” also known as Otitis Media. This is the most common type and is the usual suspect in children. However, 2 other types exist including swimmer’s ear (otitis externa) and an inner ear infection. To read about either of these 2 other types of infections please click on them now.

Imagine you were the size of an ant and you were able to walk into someone’s ear through the hole in the side of their head. You would walk through a tunnel with a few twists and turns until you came to a tight drum-like sheet called the ear-drum. When doctors diagnose you or your child with “an ear infection,” they are saying you have a bacterial infection in the part of your ear that is just past your ear-drum, called the middle ear. The middle ear is the part of your ear that is especially important in hearing. This part of your ear not only includes the ear-drum itself, but also 3 tiny bones called the Malleus, Incus and Stapes. Together the ear-drum and these three tiny bones turn any sound you hear into vibrations that your brain can understand.

Why do children get ear infections so much more often then adults
There is a tube, called the Eustachian tube, that runs from your middle ear all the way down into your nose. The Eustachian tube’s job is to allow your middle ear to be at the same pressure as it is outside. A great example of this is when you pop your ears (flying on an airplane, riding in a car, etc.). When you “pop your ears” you are actually opening your own Eustachian tubes and dropping the pressure built up in your middle ears. Although your Eustachian tubes have saved you a lot of suffering in the past by relieving any pressure built up in your ears, they are also the reason for ear infections in the first place. As we discussed, your Eustachian tubes run from your middle ear all the way into your nose. As well all know, your nose is not the cleanest place in the world. In fact this is where the bacteria comes from in ear infections; they climb their way into your middle ear from your nose.

As you get older your Eustachian tube gets longer and also begins to change from a lying down position (in kids) to more of a standing up position (in adults). Because your Eustachian tubes are shorter when you are a child, the bacteria have a shorter distance to travel to get to your middle ears. Along with this, gravity plays some protective role when you are an adult as well, pulling the bacteria back down into your nose and away from your ears.

What are some of the signs and/or symptoms people with Ear infections (Otitis Media) have
1. Pain- There is a lot of pressure inside your middle ear when it is infected due to build up of bacteria and pus.
2. Decreased or muffled hearing- recall your middle ear is a big player in hearing. When your middle ear is infected, the ear drum and tiny bones cannot do their job as well and your hearing suffers.
3. Fever- usually, but not always.
4. A feeling of warmth or even burning inside the infected ear
5. Discharge or bleeding from you ear- this is usually the result of a hole forming in your ear drum due to the pressure, called a ruptured ear drum.
6. Malaise- or in other words just not feeling well.

**Most ear infections happen after having a cold for a few days. This is a big hint to your doctor and should be to you as well as a parent.**

How is an ear infection (Otitis Media) treated
In the past, doctors here in the US would send anyone home with antibiotics (mediation for bacterial infections) who had an ear infection. However, as you may or may not know there has been an increase in the number of resistant bacteria in the past. This means that the medications that normally would kill bacteria no longer work. This is from overuse of antibiotics and also from patients not taking their medication as long as they were told. To prevent this from getting any worse there has been a change in thought and practice among doctors here in the US. Now, antibiotics are really only given to people with very severe ear infections and it is taught in medical schools that people should be sent home for several days and try and let their own immune system handle the infection before medications are given. To try and help people feel more comfortable during this time, many doctors encourage pain medications and warm or cold compresses.

Some people (children most often) require surgical treatment for recurrent ear infections. Before surgery is even discussed or considered by your doctor you or your child would have to have at least 3-6 ear infections in a 6 to 12 month time period. The surgery is quite simple and involves putting tubes through the ear-drums so that fluid may drain out from behind the ear-drum. These tubes do not prevent ear infections from happening, but rather prevent any pain and discomfort that ear infections cause. Most often these tubes fall out on their own after several years, however occassionally another procedure will be required to take them out. After the tubes are removed, your ear-drum heals over and is as good as new. If you or your child has had a lot of ear infections in a short time, talk with your doctor and see if they think these tubes would be a good option.

Please consult with your primary doctor before starting any medications for pain or treatment of infections. This information is only for your education and should be used for you to better understand a diagnosis already given or to help you communicate more effectively with your doctor.

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