Children's Hospital Colorado

Otitis Media (Ear Infections)

What is otitis media?

Otitis media is an ear infection. It is the most common bacterial infection during childhood and the most common reason that a pediatrician would write a prescription for an antibiotic. Ear infections that keep returning and do not respond to antibiotics may need to be treated with ear tubes. Ear tube placement for ear infections that have failed medical therapy is the most common outpatient surgical procedure in the United States.

Ear infections can occur in the outer ear, the ear canal, the middle ear and the inner ear. By far, the most common ear infections in children are infections of the middle ear, the area behind the eardrum.

There are three types of otitis media:

  • Acute otitis media: accompanied by fever, ear pain and irritability
  • Otitis media with effusion: accompanied by hearing loss from fluid behind the eardrum
  • Recurrent (chronic) acute otitis media: acute infections that return repeatedly

What causes ear infections in children?

Ear infections can occur if the eustachian tubes do not work properly. Eustachian tubes connect the middle ear to the back of the nose. They help to drain fluid from the middle ear. Eustachian tubes in infants and young children do not work as well as they do in adults. This is because the tubes are smaller and more level, which makes it harder for fluid to drain from the ear.

Viral upper respiratory infections (common colds) can prevent the eustachian tubes from working properly because they cause fluid to build up in the ear. The fluid in the middle ear then gets infected by the bacteria that live in the tissues in our nasopharynx, the area in the back of the nose near the opening of the eustachian tubes.

Who gets ear infections?

Ear infections are very common in young children ages 6 months to 5 years, but they can affect an individual at any age. Children with Down syndrome and cleft palate are at higher risk for ear infections.

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