Healthy Living

What is a Middle Ear Infection?

What is a Middle Ear Infection?

First, let us recall the basic anatomy of the ear.

Our ear is divided into three parts: the outer ear, middle ear, and inner ear. The outer or external ear is the outermost part of the ear and consists of the ear pinna, external ear canal, and the eardrum. The eardrum separates the external and middle ear.

The middle ear consists of three small bones (malleus, incus, and stapes) and the Eustachian tube. Both the outer ear and the middle ear are responsible for the transmission of sound and hearing.  

The inner ear consists of the cochlea, vestibule, and the semi-circular canals. The cochlea contains nerve endings for hearing, whereas the vestibule and semi-circular canals contain nerve endings for balance. Therefore, the inner ear is the structure that is controlling your balance.

What is a middle ear infection?

Middle ear infection is the inflammation of the middle ear. It is also called as otitis media. Middle ear infections can occur in anyone, but children are more susceptible. Usually, middle ear infections resolve on their own without any treatment, but if your symptoms persist, you should consult your physician.

There are two types of middle ear infections, and they include acute otitis media (AOM) and otitis media with effusion (OME).

  • Acute Otitis Media (AOM)
    • The first three weeks of the middle ear infection is called an acute otitis media. Patients with AOM may complain of fever, swelling, ear pain and redness. Hearing impairment can also occur. 
  • Otitis media with effusion (OME)
    • After the initial infection has resolved, some people continue to have fluid build-up in their middle ear. This is chronic inflammation going on, but there are no signs of an acute inflammation. Otitis media with effusion is also known as glue ear, and it is the most common cause of hearing impairment in children.


What causes a middle ear infection?

There are several causes of a middle ear infection, but the most common cause is an upper respiratory tract infection, such as a cold. During an upper respiratory tract infection, continuous mucus production will block the Eustachian tube, causing fluid to build up within the middle ear. This makes it an optimal environment for bacteria to grow.

Other causes of middle ear infection include enlarged adenoids, sinusitis, and allergies.

Young children are at a higher risk of middle ear infection, because they have a shorter and more horizontal Eustachian tube, which makes it easy for the germs to reach the middle ear.

What are the symptoms?

There are many symptoms of a middle ear infection, but the most common signs and symptoms include:

  • Earache
  • Fever
  • Loss of balance
  • Discharge from the ears
  • Difficulty in sleeping
  • Hearing problems

Babies cannot communicate to complain about the pain and other symptoms; therefore, they express their symptoms in a different way compared to adults. The common signs seen in babies with an ear infection include:

  • Repeatedly tugging of the infected ear – This may be because of the earache.
  • Irritability – Your baby will be more irritable, crying more often than before due to the pain.
  • Reduced feeding – Sucking milk applies pressure on the ear drum thus exacerbating the pain.

How is middle ear infection diagnosed?

After carefully looking at your history, your doctor will examine your ears using an otoscope. Using this, they will look for signs of infection, such as redness, swelling, and presence of pus or fluid.

Following this, your doctor may carry out another examination known as the tympanometry. This test is done to check the condition of the middle ear and movement of the eardrum. During this exam, an instrument is inserted into the middle ear, and different pressures are applied to make the ear drum vibrate. This test will measure the changes and plot a graph.

How is it treated?

Treatment of a middle ear infection depends on the severity of the infection, age, and your preference. If the infection seems to be less severe, then your doctor may propose medications just to reduce the pain and fever. If the infection seems to be caused by a virus, then oftentimes no treatment is required, but if the symptoms of the infection last for more than three days, you may need antibiotics, as it could be due to a bacterial infection.

Are there any complications?

Yes, complications can occur, but they are quite rare. Some of the complications that could arise following a middle ear infection are:

  • Rupture of the ear drums
  • Permanent hearing loss
  • Infection spread to the bones
  • Infection spread to your brain

Do home remedies help?

Few home remedies have been known to alleviate the discomfort caused by middle ear infections. However, it is recommended that you discuss these with your doctor before adopting them. Common among the remedies are the following.

  • Saltwater gargling
    • Salt is known to heal a sore raw throat and in some cases gargling helps clear the Eustachian tubes. Recommended for adults and older children.
  • Heated compress
    • Placing a warm compress, like a heating pad or a warm water bottle, on the infected ear eases the pain. This is especially beneficial for babies and small children.

How can it be prevented?

Here are a few tips to avoid middle ear infection.

  • Boost your immune system
    • Ear infections are usually the result of allergies or colds, so it is vital that one protects oneself from falling sick. Eating the right kind of food, exercising, and following a routine sleep schedule can help enhance immunity. Practice good hygiene.
  • Treat infections immediately
    • It is imperative that an infection is not left to fester. Taking the right medication and treating an illness in time will help avoid secondary infections like middle ear infection.
  • Smoke free environment
    • The risk of middle ear infection among babies can be reduced by ensuring a smoke free environment. Among adults, it is advisable to reduce or cut down on smoking.

Ear infections are painful and in some cases can do long term damage to your ears. Keeping your ears clean and healthy is a great way to avoid problems.