Otitis Media… sounds serious. Or maybe it’s a new format for backing up your data files. Actually, otitis media is nothing but an infection of the middle ear. It is also something every parent will be familiar with as 95% of all children will get this type of infection before their seventh birthday.
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The middle ear is a pea-sized space directly behind the eardrum, filled with air and containing three tiny bones which transmit sound waves to the inner ear. The air enters via the eustachian tubes which connect the middle ear to the throat. This passageway helps to equalize the pressure in the middle ear, and it drains mucus and liquid from the middle ear.

During a cold, throat infection or allergy attack, the eustachian tube can swell and prevent air from reaching the middle ear which in turn can pull fluid in. The blockage prevents drainage from the middle ear — this is the path taken by bacteria and viruses into the middle ear where they multiply, causing an infection.

Otitis media occurs most often in children, especially those six months to three years of age. This is because eustachian tubes do not fully mature until the age of 7-10 years; they are shorter and more prone to blocking and infection.

The risk factors for otitis media, especially for recurring infections, include a family history of otitis media, attending a child care centre, exposure to cigarette smoke, using a pacifier, and having a condition that affects the upper airway (e.g. cleft palate).

The symptoms of a middle ear infection can be hard to identify, especially in the very young. Some of the clues may be an earache that does not go away even with treatment, a high fever (over 39C or 102F), or one lasting more than three days. Other symptoms to look for are excessive sleepiness or irritability, a skin rash, rapid or difficult breathing, and hearing loss.

Having identified some of these symptoms, a visit to the doctor is a good idea. Diagnosis will include an examination using an otoscope — yes, that thing your doctor uses to look into your ears. If the doctor diagnoses the infection, treatment will take one of two main courses: watchful waiting, or antibiotics.

For many years, treatment of acute otitis media was immediately a course of antibiotics which would ease pain within a few days and cure within a week or ten days. This strategy is being rethought because the vast majority of these infections resolve themselves on their own (80%), and because of the growing number of antibiotic-resistant bacteria.

This brings us to “watchful waiting.” If your child has an ear infection but does not seem very sick and is not at risk for complications, your physician may ask you to monitor the child for a couple of days before deciding to prescribe antibiotics. This will occur more often with an older child as they are less likely than infants to have complications.

Otitis media need not be serious, but it can have complications. One of these might be temporary hearing loss if fluid remains in the middle ear for an extended period. Eventually, the fluid will clear, but may become re-infected before it does, necessitating a new course of antibiotics.

Any infection in a child needs to be taken seriously. At the same time, it may be easily enough resolved. Caution is never a bad decision. If your child has symptoms of otitis media, see your doctor.

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Call-out: “If the doctor diagnoses the infection, treatment will take one of two main courses:
watchful waiting, or antibiotics.”