• Highlights
• Introduction
• Causes
• Risk Factors
• Symptoms
• Prognosis
• Diagnosis
• Prevention
• Treatment
• Home Remedies
• Medications
• Surgery
• Resources
• References

Ear infections

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of ear infections.

Alternative Names

Otitis media

Prognosis

Ear infections in infants less than 3 months old may indicate more serious infections, such as meningitis. But a reassuring 2002 study reported that only 4% of infants with an ear infection had a bacterial infection. Still, any sign of infection in a baby requires prompt medical attention.

Hearing Loss and Its Consequences

Evidence strongly suggests that severe cases of recurrent acute otitis media and persistent otitis media with effusion (OME) impair hearing. The effect of long-term hearing problems may have the following effects:

• Learning Delays . Hearing loss in children slows down language development and reading skills. Children with even mild hearing loss may miss spoken words and have trouble making sense out of a conversation or a lesson in school.
• Behavioral and Social Problems. Children with impaired hearing may appear to be distracted, inattentive, and unintelligent. Some have even been inaccurately diagnosed as having attention deficit hyperactivity disorder.
• Speech Problems. A few studies have found speech problems in some young children with OME.

However, results from a 2007 New England Journal of Medicine study strongly indicate that chronic middle ear effusion poses no danger for developmental delays. Researchers evaluated children who had either prompt insertion of ear tubes to drain fluid when they were younger than age 3, or delayed insertion of tubes many months later. When the children were tested at ages 9 – 11, the researchers found no differences in speech and language, auditory processing, attention, behavior, social skills, and academic achievement. As the majority of chronic ear effusion cases eventually clear up on their own, many experts now recommend against surgical intervention for most children.

Physical and Structural Injuries in the Face and Ears

Serious complications or permanent physical injuries from ear infections are very uncommon, but may include:

• Structural damage. Certain children with severe or recurrent otitis media may be at risk for structural damage in the ear.
• Cholesteatomas. Cysts in the ear called cholesteatomas are an uncommon complication of recurrent or severe ear infections.
• Calcifications. In rare cases, even after a mild infection, some children develop calcification and hardening in the middle and, occasionally, in the inner ear. This may be due to immune abnormalities.

Mastoiditis

Before the introduction of antibiotics, mastoiditis (an infection in the bones located in the skull), was a serious, albeit rare, complication of otitis media. This condition is difficult to treat and requires intravenous antibiotics and drainage procedures. Surgery may be required.

If pain and fever persist in spite of antibiotic treatment of otitis media, the doctor should check for mastoiditis. Most cases of mastoiditis are generally not associated with ear infections.

Other Possible Complications

Impaired Balance. Some studies have indicated that children with chronic OME have problems with motor development and balance.

Facial Paralysis. Very rarely, a child may develop facial paralysis, which is temporary and relieved by drainage surgery.

• Review Date: 3/6/2007
• Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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