“I think if you have a very cooperative child who should probably be over the age of four, and you can afford this machine, I think it’s a good thing to try. I think it will be somewhat successful. However, I think the jury is still out and we need to see the long-term results. I don’t think it will be harmful to your child.”

– Dr. Julie Zweig, M.D., Ear, Nose and Throat Specialist

Acute otitis media, commonly called an ear infection, usually starts when germs that cause colds or sore throats (either bacterial or viral infections) spread to the middle ear. Once in the ear, the infection can cause a buildup of pus or fluid behind the eardrum. The pressure on the eardrum can lead to significant pain in some children.

Acute otitis media is an inflammation of the area behind the eardrum (tympanic membrane) in the chamber called the middle ear. Deep within the outer ear canal is the eardrum, which is a thin, transparent membrane that vibrates in response to sound waves. The middle ear contains air and sits behind the eardrum. When the eardrum vibrates, tiny bones within the middle ear transmit the sound signals to the inner ear, inside which nerves are stimulated to relay the sound signals to the brain. The eustachian tube, which connects the middle ear to the nose, normally ventilates and equalizes pressure to the middle ear. When your child's ears "pop" when yawning or swallowing, the eustachian tube is adjusting the air pressure in the middle ear. Consider the following:

• Two out of three children under the age of 3 experience at least one episode of acute otitis media.
• Acute otitis media is the most common bacterial illness in children.
• Fifty percent of antibiotics for American preschoolers are prescribed for ear infections.

Acute otitis media is an infection that produces pus, fluid and inflammation within the middle ear. With proper medical treatment, the bacteria causing the infection can be killed. Antibiotics do not eliminate viral infections, however.

Older children often complain of ear pain, ear fullness or hearing loss. Younger children may demonstrate irritability, fussiness, or difficulty in sleeping, feeding or hearing. Fever may be present in a child of any age. These symptoms are frequently associated with signs of upper respiratory infection, such as a runny or stuffy nose or a cough. During the infection, there will usually be some temporary hearing loss. As fluid and pus disappear from the middle ear, however, hearing improves.

While the number of office visits for otitis media with effusion – middle ear fluid – have decreased over the past decade from 25 million in 1990 to just 16 million in 2000, the number of antibiotic prescriptions written for treatment has remained constant. At the same time, concerns about the rising rate of antibiotic – or antibacterial – use and resistance have emerged. Consider the following:

• Symptoms of acute otitis media include fever, ear pain or pulling at one or both ears, irritability, decreased appetite, and/or fluid coming from one or both ears.
• Children experiencing an earache or a sense of fullness in the ear, especially when combined with fever or a prior upper respiratory tract infection, should always be evaluated by a doctor.
• Ear infections are more common in children who live with someone who smokes.
• Studies have shown that up to 80 percent of acute ear infections will clear up on their own without medical treatment.
• Children whose ear infections are not treated immediately with antibiotics are not likely to develop a serious illness.

A temporary, mild hearing loss nearly always occurs with all types of otitis media. The symptoms, severity, frequency and duration of the condition vary. The American Speech-Language-Hearing Association (ASHA) puts it this way: “At one extreme is a single short period of thin, clear, non-infected fluid without any pain or fever but with a slight decrease in hearing ability. At the other extreme are repeated bouts with infection, thick ‘glue-like’ fluid and possible complications such as permanent hearing loss.” The children who experience thick “glue-like” fluid may also be at risk for persistent behavioral and developmental problems.

ASHA suggests parents watch for signs that may indicate chronic or recurring fluid in the ear, even if there is no pain or fever. Signs include:

• Inattentiveness
• Wanting the television or radio louder than usual
• Misunderstanding directions
• Listlessness
• Unexplained irritability
• Pulling or scratching at the ears

Check with your healthcare professional if you suspect your child has problems with chronic fluid in the ear.

American Speech-Language-Hearing Association
American Academy of Pediatrics
The Journal of the American Medical Association
KidsHealth
American Medical Association
National Center for Infectious Diseases