Overview of Ear Infections

Keeping our children's ears healthy is important not only to their physical well-being but also to their language development and academic achievement. Ear infections are one of the most common childhood illnesses diagnosed in the United States.

The way the ear works has an important effect on how ear infections occur. The ear is composed of three regions: the outer ear, middle ear, and inner ear. The most common ear infections in children occur in the middle ear. Middle ear infections are called otitis media.

The middle ear is made up of the following:

  • Eardrum or tympanic membrane (thin membrane that vibrates when sounds enter the ear)
  • Auditory ossicles (three tiny bones that transmit vibration from the eardrum to the inner ear)
  • Eustachian tube (also called the auditory tube; small tube that allows fluid that accumulates inside the ear to drain into the back of the throat)

In many cases, the eustachian tube is where problems arise regarding middle ear infections. When a child gets a cold (i.e., upper respiratory infection), swelling in the throat can cause a blockage in the eustachian tube, trapping fluid in the middle ear. Bacteria or viruses can grow in this trapped fluid and create pressure that pushes against the eardrum. Pressure in the middle ear can result in pain and muffled hearing, and can cause the ears to feel plugged.

Middle ear infection with significant pain is called acute otitis media (AOM). Other symptoms of AOM may include fever, vomiting, diarrhea, mild to moderate hearing loss, and tiredness.

In some cases, fluid remains in the middle ear even after the pain of AOM goes away. Children can also have fluid in the middle ear without ever having AOM. Fluid in the ear with no acute symptoms is called otitis media with effusion (OME). OME can last from days to weeks.

When children have OME frequently, or for long periods of time, the condition can interfere with hearing. Because a very young child needs to hear clearly to learn how to speak, chronic OME can delay language development.

If your child frequently has fluid in the middle ear that interferes with hearing, his or her pediatrician may recommend ear tubes. Ear tubes, also called ventilating tubes, allow the fluid in the middle ear to drain into the outer ear canal. Ear tubes can improve hearing and reduce the number and severity of ear infections in children. Hundreds of thousands of ear tube insertions are performed each year in the United States.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 27 Aug 2008

Last Modified: 14 Sep 2015