Middle Ear Infection

A middle ear infection (also called otitis media) is an infection behind your eardrum. It can happen after any condition that traps fluid in the middle ear, such as a cold, allergies, sore throat, or respiratory infection. Middle ear infections are common in children, but they can be more serious when they happen in adults.

Types of Middle Ear Infections

Infections can affect the middle ear in several ways, including:

• Acute otitis media: A sudden infection where fluid and pus get trapped under the eardrum. Symptoms may include swelling, redness, fever, and pain.
• Chronic otitis media: An ongoing or recurring infection over months to years. It is usually not painful but can involve hearing loss. The ear canal may drain liquid.
• Otitis media with effusion: After an infection goes away, fluid (effusion) and mucus build up, causing your ear to “feel full.” This can go on for months and may affect hearing.
• Chronic otitis media with effusion: Fluid (effusion) remains in the middle ear for a long time or builds up repeatedly, even though there is no infection. This may also affect hearing.

Symptoms of Middle Ear Infection

Common symptoms of a middle ear infection in adults are:

• Pain in one or both ears
• Drainage from the ear
• Muffled hearing
• Sore throat 
• Fever
• Balance problems (this is rare)

Causes of Middle Ear Infection

The middle ear connects to the throat by the eustachian tube. A cold or allergy can irritate this tube or cause it to swell, blocking fluid from draining from the ear. The fluid builds up behind the eardrum allowing the growth of bacteria and viruses that cause infection.

You are more likely to get an ear infection if you:

• Smoke or are around someone who smokes
• Have allergies
• Have a cold or other upper respiratory infection

Diagnosing Middle Ear Infection

Your health care provider will take a medical history and do a physical exam. They will use special instruments to examine the outer ear and eardrum. They may also do a test called tympanometry (which tells how well the middle ear is working) or check your hearing with a tuning fork.

Occasionally, a CT scan or MRI is needed to check for rare causes such as a cholesteatoma or tumors.

Treatments for Middle Ear Infection

Contact your health care provider if your symptoms don’t improve in 48 to 72 hours. If you have a middle ear infection that doesn’t improve, you should see an ear, nose, and throat specialist (otolaryngologist) or a specialized otologist. Without treatment, middle ear infections can cause problems such as infection in other parts of the head, permanent hearing loss, and paralysis of a facial nerve.

Your treatment will depend on the type of infection you have. A middle ear infection may be treated with the following:

• Antibiotics, taken by mouth or as ear drops
• Medication for pain
• Decongestants, antihistamines, or nasal steroids
• An ear tube (for chronic otitis media with effusion)

Your health care provider may also have you try autoinsufflation, which helps adjust the pressure in your ear. For this, you pinch your nose and gently exhale, forcing air back through the eustachian tube.

Sometimes fluid stays in the middle ear even after you take antibiotics, and the infection goes away. In this case, your health care provider may suggest placing a small tube at the opening of the eardrum to keep fluid from building up. It can also help you hear. This procedure is sometimes called a myringotomy, and an otolaryngologist or specialized otologist performs it. It is a routine procedure in adults that takes under five minutes in the office. The tubes usually fall out on their own after six months to a year.

Why Choose Columbia

Our specialists understand the profound impact that diseases of the ear can have on our patients’ daily lives. That’s why our team of physicians and audiologists is committed to making sure you get the right care as quickly as possible. Using sophisticated tools and the best available therapies, we have extensive experience diagnosing middle ear infections and choosing the best treatment plan for you.