In the era of modern medicine, middle ear infection rarely leads to mortality, except in rare cases of intracranial spread of infection. Eustachian tube dysfunction (ETD) and chronic otitis media with effusion (COME) affect 70% of children by age 7 years and are common causes of childhood hearing loss. Males have a higher prevalence of acute otitis media (AOM) and undergo myringotomies and tympanoplasties more frequently than females do. Middle ear dysfunction and eustachian tube dysfunction (ETD) are more common in the pediatric age group. Peak incidence of otitis media (OM) is in the first 2 years of life.
The onset of signs and symptoms of ear infection is usually rapid. Signs and symptoms common in children include: Ear pain, Tugging or pulling at an ear, Difficulty sleeping, Crying, Acting more irritable than usual, Difficulty hearing or responding to sounds, Loss of balance, Fever of 100 F (38 C) or higher, Drainage of fluid from the ear, Head ache, loss of appetite etc. Most ear infections resolve without treatment with antibiotics. Symptoms of ear infections usually improve within the first couple of days, and most infections clear up on their own within one to two weeks without any treatment. The American Academy of Pediatrics and the American Academy of Family Physicians recommend a wait-and-see approach as one option for: Children 6 to 23 months with mild inner ear pain in one ear for less than 48 hours and a temperature less than 102.2 F (39 C). Children 24 months and older with mild inner ear pain in one or both ears for less than 48 hours and a temperature less than102.2 F (39 C).
Middle ear and eustachian tube inflammation are common denominators in various clinical conditions, namely, acute otitis media (AOM), chronic otitis media with effusion (COME), and eustachian tube dysfunction (ETD). Acute otitis media (AOM) can be described on the cellular and molecular level as a transudation of neutrophils, serum, and inflammatory mediators into the middle ear space. This transudation is associated with mucosal edema of the middle ear and bacterial or viral infection of the eustachian tube and middle ear space. Chronic otitis media (COM) involves a transudation of serum with less cellularity of the effusion material. Because ear infections often clear up on their own, treatment may begin with managing pain and monitoring the problem. Ear infection in infants and severe cases in general often require antibiotic medications. Long-term problems related to ear infections - persistent fluids in the middle ear, persistent infections or frequent infections-can cause hearing problems and other serious complications.