Auditory System Hearing Disorders Otitis Media

Otitis media is the clinical term for a middle ear infection. The chamber behind the tympanic membrane (eardrum) houses the small bones which help transmit sound to the cochlea in the inner ear. This chamber can become filled with fluid, which can become infected by bacteria or viruses.

This is a common disorder in young children. Many ear infections clear up spontaneously, but others may require antibiotic treatment.

Otitis Media Causes

Otitis media is caused by a chain reaction of factors. The eustachian tube connects the middle ear with the back of the throat, and functions to equalize middle ear pressure. Normally, middle ear pressure is equalized with the atmospheric pressure (pressure outside the ear).

However, when the eustachian tube is blocked, negative pressure builds in the middle ear and fluid can collect, encouraging bacterial growth. Otitis media often (but not always) develops after a cold, which can cause the swelling that leads to eustachian tube dysfunction. Children have smaller eustachian tubes than adults, contributing to the greater number of ear infections in children than in adults.

Otitis Media Symptoms

The primary symptom of an otitis media ear infection is pain or discomfort. In very young children (those who are too young to tell parents, “my ear hurts”), otitis media should be suspected if you observe:

  • Crying
  • Fever
  • Pulling at ears
  • Trouble sleeping.

Older children and adults may complain of:

  • Headache
  • Ear blockage
  • Pain
  • Fever.

Hearing may be muffled because the fluid in the middle ear can reduce the mobility of the eardrum (with the pressure of the fluid against the eardrum) in otitis media. Acute cases may results in eardrum rupture from excessive pressure behind the eardrum.

Otitis Media Treatment

Many cases of otitis media may clear on their own. If your child is showing possible signs of otitis media, make an appointment with your pediatrician, who will examine the affected ear(s). She may then recommend a waiting period before prescribing medication, particularly if the infection is mild or in its early stages. More severe infections may require oral antibiotics.

Chronic Otitis Media

Many children have chronic, recurrent ear infections. If this is the case for your child, your pediatrician may recommend a procedure called a myringotomy, otherwise known as:

  • Ear tubes
  • Pressure equalizer(PE)tubes
  • Tympanostomy tubes.

Acute Otitis Media - Otitus Media - Hearing Disorders

These tubes are inserted into the ear, making a two-way valve for air. This helps the middle ear to maintain healthy pressure when the eustachian tube is not functioning properly. This procedure is performed by an otolaryngologist (also called an ENT).

These tubes remain in the eardrum for eight to twelve months, and are extruded naturally. If your child has PE tubes, she should avoid getting water in her ears, as it can pass through the tube and into the middle ear. Your ENT may make specially molded earplugs so your child can bathe and swim (with her head above water) safely.


KidsHealth (n.d.). Middle ear infections. Retrieved February 10, 2010, from KidsHealth Web site:

Mayo Clinic (n.d.). Ear infection, middle. Retrieved February 10, 2010, from Mayo Clinic Web site:

National Institute on Deafness and Other Communication Disorders (n.d.). Otitis media (ear infection). Retrieved February 10, 2010, from National Institute on Deafness and Other Communication Disorders Web site:

Texas Pediatric Surgical Associates (n.d.). Tympanostomy tubes. Retrieved February 11, 2010, from Texas Pediatric Surgical Associates Web site: