Otitis Media (Ear Infections)

What are the symptoms of an ear infection?

Symptoms of a middle ear infection in children can include:

• Fever
• Pain
• Irritability
• Ear drainage
• Hearing loss
• Ear tugging

Sometimes, a child may have no symptoms and the middle ear fluid is found by a clinician during a routine examination.

What tests are used to diagnose ear infections?

Otitis media (middle ear infections) are diagnosed by a thorough examination and history. On examination, the area behind the eardrum will be full of pus or fluid. When air pressure is applied to the eardrum, it won't move due to fluid buildup. Occasionally a hearing test will be given to your child to see if the fluid in the middle ear has caused any hearing loss.

What can we expect from a hearing test?

There are two types of hearing tests:

• A tympanogram is a pressure test to tell if the eardrum is normal (moving) or not moving (has fluid behind the drum) and it takes three minutes.
• A formal hearing test (audiogram) usually takes 10 to 20 minutes.

These tests are given by an audiologist. The tests are tailored to each child based on their clinical condition as well as their age and development. There should be no or minimal discomfort during these tests.

How is an ear infection treated?

Your child's ear infection may clear up on its own without any treatment. Middle ear infections may be treated with antibiotics. Antibiotics are reserved for children who have an acute infection with symptoms. Over the past two decades, there has been an increase in drug-resistant strains of bacteria that cause ear infections. This contributes to the failure of medical therapy. If the fluid will not go away, ear tube surgery may be needed.

How can I help relieve my child's ear pain at home?

To manage pain at home, you may give acetaminophen (Tylenol) or ibuprofen (Motrin) to your child. Call your doctor if you have any questions.

What is ear tube surgery?

Ear tube surgery is a 10-minute outpatient procedure under general anesthesia to place ear tubes. Anesthesia is the use of medicines called anesthetics to make your child unable to feel pain during an operation or procedure. The surgeon will make a small incision in the eardrum and clean fluid out of the middle ear. The surgeon will then place a small, hollow tube in the incision. The tube is usually made from surgical-grade plastic or metal.

The purpose of the ear tube is to equalize pressure between the middle ear and the environment. The ear tubes allow extra fluid from the infection to drain out, which reduces inflammation and allows the ear to heal. This procedure can help reduce ear infections and resolve symptoms, including hearing loss.

Your surgeon may recommend that your child have an adenoidectomy at the same time as ear tube surgery. An adenoidectomy is surgery to remove the adenoid. The adenoid is lymphoid tissue located behind the nose. It helps fight off infection by trapping bacteria that enter through the mouth. In some cases, bacteria can get trapped in the adenoids and lead to chronic infections. An adenoidectomy may be recommended if your child needs a second set of tubes or has significant nasal obstruction (blockage) from enlarged adenoids.

What can we expect after my child's ear tube surgery?

Ear tubes generally stay in place for six to 12 months. The ear tubes will then fall out on their own. The most common complication of the procedure is ear drainage, which generally responds to antibiotic ear drops. Rarely, a small hole may remain on the eardrum (in about 1% of children) after the tube falls out.

Your surgeon will see your child again three to four weeks after surgery to make sure the tubes are working well and to do a hearing test. Your child will then be followed every nine to 12 months after that until the tubes have fallen out. There is a 30% chance that your child will need more than one set of tubes.

Why choose Children's Hospital Colorado for ear infection treatment?

The Ear, Nose and Throat Program doctors and audiologists at Children's Colorado have additional training in caring for children. We are at the top of our field in treating children with ear, nose and throat disorders, including ear infections.

• National Institutes of Health provides additional details about ear infections such as prevention and research that's being done on otitis media. 
• The American Academy of Otolaryngology–Head and Neck Surgery provides more information about otitis media and in-depth information on ear tube surgery.