Inflammation of the middle ear is an infection caused by a germ (bacterium). It is very common among children. The middle ear is an air-filled hollow between the eardrum and the inner ear. The Eustachian tube - an air channel between the middle ear and the nose - usually ensures that the middle ear is ventilated and that fluids can run out through the nose.

Middle ear infection most commonly occurs following a cold. It also frequently occurs as a result of contact with other children. Middle ear infection (called otitis media) is an infection behind the eardrum. Ear infections are very common and are usually painful. By the age of six, most children have grown out of middle ear infections and are not likely to suffer long-term problems.

Symptoms

In otitis media, inflammation occurs on that portion of the ear, which is directly behind the eardrum. This pain in the ear is usually of a piercing type and is not attended with fever. Pus is discharged into the outer ear. As the condition progresses, the inner ear becomes seriously affected, and hearing is considerably impaired.

Acute middle ear infection is most common in children. It is caused by a bacterial or viral infection of the fluid of the middle ear. When infection occurs in the middle ear, pus or excess fluid is produced. Ear infections are often associated with respiratory infections or with blocked sinuses caused by allergies or enlarged adenoids.

Causes

A cold or other infection of the upper airways causes the tubes which drain the ears in to the back of the throat to become swollen and filled with mucus or catarrh. These tubes are called eustachian tubes, and are the tubes we open, by yawning or swallowing, to stop our ears popping as we go up a hill or in a plane. This swelling may block the eustachian tubes, and stop the normal drainage of fluid from the middle ear down to the back of the throat. As water which is stagnant becomes foul, so there is more chance of germs building up in this stagnant situation in the middle ear, and a middle ear infection (acute otitis media) is the result.

Ear infections also can be associated with dysfunction or swelling within the eustachian tubes — the narrow passageways that connect the middle ear to the nose. Normally these tubes equalize pressure inside and outside the ear. But a child's eustachian tubes are narrower and shorter than those of an adult. This makes it easier for fluid to get trapped in the middle ear when the eustachian tubes dysfunction or become blocked during a cold.

Treatment

Many physicians recommend the use of an antibiotic (a drug that kills bacteria) when there is an active middle ear infection. If a patient is experiencing pain, the physician may also recommend a pain reliever. Following the physician's ear infection treatment instructions is very important. Once started, the antibiotic should be taken until it is finished. Most physicians will have the patient return for a follow-up examination to see if the infection has cleared.

Most ear infections clear on their own in just a few days — and antibiotics won't help an infection caused by a virus. In fact, about 80 percent of children with acute otitis media recover without antibiotics, according to the AAP and AAFP. If your child is uncomfortable, the doctor may recommend an over-the-counter pain reliever such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others). If your child doesn't have drainage from the ear or ear tubes, prescription eardrops containing a local anesthetic may be an option, too. The drops won't cure the infection, but they may relieve pain.