Otitis Media (Cleveland Clinic)

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What is otitis media?
Otitis media is a bacterial or viral infection of the middle ear (the space behind the eardrum). Middle ear infections often occur as a complication of a cold, allergies, nose and throat infection, or enlarged adenoids (glands at the top of the throat). Middle ear infections usually clear up without complication or long-term effects.

The ear structure and function
There are three main parts of the ear: outer, middle, and inner. The outer ear is the orifice outside of the body. The middle ear houses delicate bones that aid in hearing, and the inner ear holds organs that control hearing and balance. The Eustachian tube regulates air pressure within the middle ear, connecting it to the back of the nose and throat.

What are the symptoms of otitis media?
Ear infections can be painful. Trapped fluid puts pressure on the eardrum, causing it to bulge. Other symptoms include:

  • Ear pain: This symptom is obvious in older children and adults, but for children who cannot yet speak, you should watch for other signs, like irritability or excessive crying.
  • Loss of appetite: This may be most apparent in young children, especially during bottle feedings. Pressure changes in the middle ear as the child swallows, causing more pain and less desire to eat.
  • Irritability: Any kind of persistent pain may cause irritability in children and adults.
  • Poor sleep: Pain may be more persistent when lying down as fluid is shifting.
  • Fever: Ear infections can cause temperatures up to 104°F.
  • Drainage from the ear: Yellow, brown, or white fluid that is not earwax may seep from the ear. This may indicate the rupture of the eardrum.
  • Difficulty hearing: Bones of the middle ear connect to the nerves that transmit electrical signals as sound to the brain. Fluid behind the eardrums slows down movement of these electrical signals through the inner ear bones.

Who is most likely to get middle ear infections?
Middle ear infection is more common in children and is the most prevalent childhood illness other than a cold. Ear infections occur most commonly between age 3 months and 3 years and are common until age 8. One-fourth of all children will have repeated ear infections; and five to ten percent will develop a hole on the eardrum from fluid pressure. This hole usually heals in one week.

For many reasons, children usually get more ear infections than adults. First, they usually get more colds and respiratory infections than adults. Second, the Eustachian tube is shorter and has less of a slope in children than in adults.

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Last Updated: 1/9/2012

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