Middle Ear Infection(Otitis Media) – Symptoms, Causes, and Treatment

An earache can make it difficult for an individual to focus or pay attention to their work. The individual may also experience dizziness and fatigue due to severe ear pain. Evidently, doctors claim that the majority of the cases of earache is due to middle ear infection. Consider this article as a guide to understand the symptoms, causes, risk factors, diagnosis, and treatment of middle ear infection. 

What is Middle Ear Infection? 

The infection that develops behind the eardrum is known as a middle ear infection. It is also termed as Otitis Media. These ear infections are more common in children than adults. However, otitis media in adults tends to be more fatal than in children. Hence, the doctor may recommend additional tests such as CT scans or MRIs. 

When any factor prevents the ear from draining the fluid properly, this is the type of ear infection that develops. Some of the common factors that restrict the drainage include common cold, allergies or any respiratory infection. People who are susceptible to developing otitis media should seek professional help. 

Types of Middle Ear Infection 

A person can experience any one of the following types of otitis media or middle ear infection in the ears-

  • Acute Otitis Media- This is the type of middle ear infection that develops all of a sudden. This results in swelling as well as redness of the ear. The pus and fluid get trapped behind the eardrum resulting in fever and excessive ear pain. 
  • Chronic Otitis Media- The otitis media is termed chronic when the middle ear infection develops repeatedly and doesn’t cure easily. Surprisingly, there is no sign of any pain. The infection can stay for months and even years. Eventually, delaying the treatment of chronic otitis media can lead to perforation of the eardrum. Hence, the affected person can also suffer from hearing loss. 
  • Otitis Media with Effusion- Sometimes, there is a buildup of fluid and mucus in the middle ear resulting in the fullness of the ear. This is known as effusion and can lead to partial hearing loss. 
  • Chronic otitis media with Effusion- The fluid build-up behind the eardrum stays for a very long time or develops repeatedly, even though the infection has cured on its own. 

Symptoms of Middle Ear Infection

Primarily, a patient suffering from middle ear infection has severe ear pain. Along with the ear pain, the earache, he or she may experience any one or a combination of the following symptoms-

  • Extreme irritability
  • Unable to sleep properly
  • Fever
  • Discharge of yellow, clear or blood pus
  • Pulling or tugging the ears 
  • Loss of balance
  • Unable to hear properly
  • Nausea and vomiting 
  • Loss of appetite
  • Diarrhea
  • Nasal congestion 

Causes of Middle Ear Infection 

There is a tube running from the middle ear to the throat through a canal known as the Eustachian tube. The primary objective of this tube is to maintain the pressure between the outer ear and inner ear. A couple of times, due to factors such as inhaling an allergen or cold symptoms, the tube can inflame and swell. Due to this, there can be an excessive build-up of fluid as the tube gets blocked. The accumulated fluid behind the eardrum can get infected due to bacteria and viruses. Hence, there is a resultant ear infection in the middle ear. 

Risk factors for Middle Ear Infection 

The chances of a middle ear infection developing are higher in people who-

  • Smokes or stays around people who smoke
  • Suffering from allergy symptoms during season change or round the year
  • Suffering from cold or other upper respiratory infection 

Diagnosis of Middle Ear Infection

The diagnosis of middle ear infection can be performed by a doctor in various ways. The ENT Specialist can use any one of the following ways for diagnosing-

  • Using an otoscope-  Using this instrument, the doctor looks into the patient’s ear and checks for any redness, swelling, discharge, fluid or hole in the eardrum.
  • Tympanometry- With the help of a small instrument, the ENT Specialist tests the air pressure of the ear to check if there is any perforation in the eardrum.
  • Reflectometry- In this test, the doctor makes a sound near the patient’s ears using a piece of special equipment. This helps to determine the doctor if there’s a fluid buildup inside the ear. 
  • Hearing test- A hearing test, also termed as an audiogram, can measure the quietest sound that an individual can hear across the speech range. 

Treatment of Middle Ear Infection 

Within 2-3 days the symptoms of middle ear infection alleviate. However, fluid build-up may stay for more than 3 months. Depending on the severity of the infection, the underlying cause of the infection and the patient’s immunity,  the doctor recommends the appropriate treatment option.

Delaying the treatment of otitis media leads to-

  • Infection of other parts of bone inside the ear
  • Loss of hearing permanently
  • Paralysis of nerve in face 

Generally, the doctor recommends any one of the following treatment options after thorough diagnosis.

  • Taking antibiotics in case the cause is a bacterial attack
  • Pain medicines such as acetaminophen or ibuprofen 
  • Inhaling decongestants, nasal steroids or antihistamines 
  • To maintain ear pressure, sometimes the doctor try autoinsufflation 

In rare cases, the infection may cure with antibiotics but the fluid may still be present. To remove the fluid, the doctor can suggest myringotomy. In this procedure, the doctor places a small tube inside the ear during surgery. The tympanostomy tube is placed near the eardrum opening to prevent fluid build-up as well as relieve excessive pressure inside the ear.  Once the purpose in fulfilled, the tube can fall out on their own within a year. 

Prevention of Middle Ear Infection 

Middle ear infections can be easily prevented. Here are some tips that doctors recommend-

  • Breastfeeding the child as the mother’s milk is rich in immunity-boosting properties.
  • All types of vaccines should be taken during childhood.
  • Avoid inhaling smoke or secondhand smoke as this can increase the risk ear infections in the child. 
  • Wash hands frequent;y to remove the germs.


Middle ear infection or otitis media is a common type of ear infection that can affect all age groups. Although it is not a fatal condition, delaying its treatment can lead to the spreading of the infection to the other parts of the ear or permanent hearing loss. Therefore, in case the symptoms don’t subside within 2-3 days, the patient should visit an ENT doctor without any further delay. Meanwhile, one can try various home remedies to reduce the earache caused due to middle ear infection. 


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