It’s the middle of the night and your toddler is crying, irritable, and unable to settle down. Your frustrated because they can’t tell you what’s wrong. Then you notice they’re tugging at one ear and the problem becomes apparent. The poor little bit probably has a middle ear infection. For parents of older children, they can tell you what’s troubling them but it’s unlikely they know the exact reason for their discomfort.
Though some are more prone to different types of ear infections such as swimmers’ ear, which affects the outer ear, an infection of the middle ear is one that is most often attributed to hearing loss in children. While all types of ear infections can be the underlying cause of short-term hearing loss, chronic or repeat middle ear infections can result in more time spent with diminished hearing.
For babies and small children, this is a critical time period where learning speech and language skills are imperative. The more time spent with hearing loss, the more delayed a child’s speech and cognitive skills become. Acute otitis media or middle ear infections can result in a buildup of fluids in the space located just behind the eardrum which is normally filled with air. This is known as otitis media with effusion.
This type of infection is almost always preceded by a cold or upper respiratory infection. Youngsters are more at risk than older children due to the fact that they have lower immunity and their little bodies have a tougher time fending off infections. Also, because their Eustachian tube, a small canal that controls the air pressure within the middle ear, are positioned on a more horizontal level which makes it difficult for any fluid buildup to drain on its own.
Children who suffer from chronic infection of the tonsils or adenoids are also at risk for middle ear infections. Located close to the Eustachian tube, bacteria and viruses are able to access these areas with little trouble. Many children who have chronic issues with the tonsils or adenoids are candidates for surgery to remove these glands.
An ear, nose, and throat specialist can perform an adenoidectomy or tonsillectomy which will alleviate the possibility of repeat infections in the future. Once the surgery is performed and the area has healed, the patient will see an improvement in the condition.
Due to irritation and swelling at the back of the throat, the Eustachian tube is unable to equalize this pressure to the air outside the body. This causes a buildup of pressure within the minuscule middle ear area and when combined with the horizontal angle of the tubes, normal secretions are unable to flow out naturally.
The overabundance of fluid and negative pressure within the middle ear can cause dizziness, ear pain, excessive pressure, and even short-term hearing loss. Other symptoms include:
- Frequent repeated tugging of the ear
- Fluid draining from the ear
- Slower response to speakers and sounds (which can indicate trouble hearing)
In the case of older children, teens, and even adults, symptoms to look for are:
- Constant ear pain
- Difficulty understanding speech
- Dizziness or balance issues
- Feeling of pressure within the ear
- Nausea or vomiting
Doctors can diagnose a simple case of middle ear infection quickly, by evaluating the symptoms and looking inside the ear with an instrument called an otoscope. While healthy eardrums will appear a pinkish-grey color and clear, an infected eardrum will appear inflamed and red in color.
A doctor can check the fluid in the middle ear by using a pneumatic otoscope. This device directs a tiny amount of air towards the eardrum, which should move easily back and forth. If there is fluid present, it won’t move as freely. Tympanometry is another test that can be used, which uses air pressure and sound to detect fluids within the middle ear.
Treatment of middle ear infections usually involves getting the pain under control with the use of over-the-counter acetaminophen and ibuprofen. Sometimes ear drops containing pain medication are prescribed to help as well. If symptoms don’t improve, your doctor might prescribe an antibiotic to help fight the infection through the American Academy of Pediatrics has different recommendations based on age and symptoms.
Children less than six months old can be prescribed antibiotics for acute otitis media. Children from six months to twelve years if symptoms are severe, though observation is an option for non-severe cases. Typically, a 48- to 72-hour observation period is requested to see if the symptoms clear up on their own.
While hearing loss can be detrimental to a child’s learning and older individuals must deal with the frustration of reduced hearing as well as the pain, the effects of any hearing loss due to middle ear infections are usually temporary. These short-term effects will usually subside once the infection is treated. When the pressure within the middle ear is alleviated, this allows the ear canal to open back up, but it will only happen after the infection is resolved.
If you suspect you or your child has an ear infection, schedule an appointment to get checked out. A simple diagnosis could quickly and easily end any discomfort and reduce the chances of any loss of hearing at all.