Otitis Media

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What Is an Ear Infection?

An ear infection, or otitis media, is the most common cause of earaches. Although this condition is a frequent cause of infant distress and is often associated with children, it can also affect adults.

The infection in the middle ear (the space behind the eardrum where tiny bones pick up vibrations and pass them along to the inner ear) very often accompanies a common cold, the flu, or other types of respiratory infections. This is because the middle ear is connected to the upper respiratory tract by a tiny channel known as the eustachian tube.


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Untreated, ear infections can lead to more serious complications, including mastoiditis (a rare inflammation of a bone adjacent to the ear), hearing loss, perforation of the eardrum, meningitis, facial nerve paralysis, and possibly -- in adults -- Meniere's disease.

What Causes an Ear Infection?

The middle ear is a small space behind the ear drum that is supposed to be well ventilated by air that normally passes up from behind the nose, through the eustachian tube, keeping the middle ear clean and dry.

In children and infants, the eustachian tube is often too soft or immature and has a harder time staying open. Allergies, post nasal drainage, sinus infections, and adenoid problems can all interfere with the eustachian tube’s ability to let air pass into the middle ear.

When the doctor looks at the ear drum, he or she will see that it is red, often bulging, and be able to make the diagnosis of an ear infection.

For children, the most common cause of an ear infection is an upper respiratory viral infection, such as a cold or the flu. These disorders can make the eustachian tube so swollen that air can longer flow into the middle ear.

Allergies -- to pollen, dust, animal dander, or food -- can produce the same effect as a cold or flu, as can smoke, fumes, and other environmental toxins. Bacteria can cause an ear infection directly, but usually these organisms come on the heels of a viral infection or an allergic reaction, quickly finding their way into the warm, moist environment of the middle ear. Invading bacteria can wreak major havoc, turning inflammation into infection and provoking fevers.

Flu shots do not offer protection from ear infections. However, according to the American Academy of Otolaryngology, Head and Neck Surgery (ear, nose, and throat physicians), the conjugate pneumococcal vaccine is very effective against several strains of the most common bacteria which causes ear infections. This vaccine is given to infants and toddlers.

Your child’s doctor should advise you on the use of this vaccine, which may help to prevent ear infections.

Ear infections occur in various patterns. A single, isolated case is called an acute ear infection (acute otitis media). If the condition clears up but comes back as many as three times in a six-month period (or four times in a single year), the person is said to have recurrent ear infections (recurrent acute otitis media).


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