Middle Ear Infections

What is a middle ear infection?


Middle Ear InfectionMiddle ear infections occur behind the eardrum. In many cases, both ears are affected.


Middle ear infections are most common in young children, whose ear anatomy is not fully developed. Children under age 5, boys, bottle-fed infants and children in daycare run the greatest risk of infection. Although much less common, middle ear infections can also occur in older children and adults.


Middle ear infections can be painful and they tend to disrupt sleep- for you as well as for your child. But this isn’t the full extent of the problem. Middle ear infections can also limit the eardrum’s flexibility, reducing your child’s ability to hear. This could make it harder for your child to learn to talk. Depending on when the hearing problem starts and long it lasts, your child’s learning ability could be affected.


Middle ear infections are usually caused by bacteria or viruses. In young children these germs probably reach the middle ear by traveling the short length of the eustachian tube from the throat. Once in the middle ear, they multiply and spread. This irritates the delicate tissues lining the middle ear and eustachian tube. If the eustachian tube lining swells enough to block off the tube, air pressure drops in the middle ear. This pulls the eardrum inward, making it stiffer and less able to transmit sound.


Once the eustachian tube swells shut, moisture can’t drain from the middle ear. Instead, fluid builds up in the chamber. This may raise pressure behind the eardrum, decreasing pain slightly. But if the infection spreads to this fluid, pressure behind the eardrum shoots way up. The eardrum is forced outward, becomes painful and may break.


If the eardrum doesn’t break and the tube remains blocked, the fluid becomes chronic (an ongoing condition). As the acute (immediate) infection passes, the middle ear fluid thickens. It becomes sticky and takes up less space. Pressure drops in the middle ear once more. Inward suction stiffens the eardrum, affecting hearing. If the fluid is not removed, the eardrum may be stretched and damaged.


Tube Placement


In some cases, medical care (antibiotics) alone cannot control middle ear problems. If your child has hearing loss or if fluid still remains after several months, surgery may be recommended to treat the middle ear. Our physicians will discuss this procedure with you and answer any questions you may have.


During the surgery, the physician removes the fluid from the middle ear and places a tiny tube in the eardrum. This tube creates a very small tunnel between the outer ear canal and the middle ear. This tunnel balances air pressure on both sides of the eardrum and prevents fluid buildup, even if the eustachian tube becomes blocked again. In most cases, surgery can be performed on both ears in less than 30 minutes.


What is the Eustachian Tube?


As the link between the middle ear and the throat, the eustachian tube has two roles. It helps drain normal, cleansing moisture from the middle ear. It also controls air pressure inside the middle ear chamber. When you swallow, the eustachian tube opens. This balances the air pressure in the middle ear with the pressure outside the eardrum. In infants and young children, the eustachian tube is short and almost level with the ear canal. By about age 7, however, the eustachian tube has become longer and steeper. This improves how well it works.


What is the Middle Ear?


The middle ear is an air-filled chamber that lies behind the eardrum. Pressure in the middle ear changes to match air pressure outside of the eardrum. When inside and outside pressure is balanced, the eardrum is flexible and normal hearing is more likely. Problems occur when air pressure in the middle ear drops. This is usually due to a block in the eustachian tube, the narrow channel connecting the ear with the back of the throat.

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