An ear infection (acute otitis media) is most often a bacterial or viral infection that affects the middle ear, the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear. Children are more likely than adults to get ear infections. Ear infections frequently are painful because of inflammation and buildup of fluids in the middle ear.
There are two types of middle ear infections: acute otitis media (AOM) and otitis media with effusion (OME). AOM type of ear infection comes on quickly and is accompanied by swelling and redness in the ear. Fever, ear pain, and hearing impairment often occur as a result of trapped fluid and/or mucous in the middle ear. OME occurs when an initial infection is followed by mucous and fluid buildup in the middle ear. This can cause the feeling of the ear being “full” and affect your ability to hear clearly.
More than two-thirds of children experience one or more attacks of AOM by the age of 3 and about half experience more than three episodes. The peak age of incidence is 6 to 24 months and decreases with age. It is less common at school age. Otitis media occurs more in the winter than summer months, as it is usually associated with a cold.
It can occur in adults but this is most unusual. There are a number of reasons why children get middle ear infections. They often stem from a prior infection of the respiratory tract that spreads to the ears. When the tube that connects the middle ear to the pharynx (Eustachian tube) is blocked, fluid will collect behind the eardrum. Bacteria will often grow in the fluid, causing pain and infection. There are a variety of symptoms associated with middle ear infections.
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 use of over-the-counter acetaminophen (Tylenol, others) or ibuprofen (Motrin IB, Advil, others) to relieve pain. Prescription eardrops, such as antipyrine-benzocaine-glycerin (Aurodex), may provide additional pain relief for those whose ear drums are intact (not torn or perforated). Chronic infection that results in perforation of the eardrum — chronic suppurative otitis media — is difficult to treat. It's often treated with antibiotics administered as drops. During an outpatient surgical procedure called a myringotomy, a surgeon creates a tiny hole in the eardrum that enables him or her to suction fluids out of the middle ear. A tiny tube (tympanostomy tube) is placed in the opening to help ventilate the middle ear and prevent the accumulation of more fluids. Some tubes are intended to stay in place for six months to a year and then fall out on their own. Other tubes are designed to stay in longer and may need to be surgically removed. The eardrum usually closes up again after the tube falls out or is removed.