Otitis media is an infection or inflammation generally caused by viruses or bacteria entering the middle ear.  It often occurs after a child has a cold, sore throat, or other respiratory problem.  It is primarily a disease of infants and young children with 75% of children experiencing at least one episode by their third birthday. Many children will have three or more infections before they turn three.

The ear is composed of three parts - the outer ear, the middle ear, and the inner ear.  The outer ear includes the part you can see and the ear canal.  It ends at the eardrum.  The middle ear is an air-filled chamber containing 3 small bones that transmit sound to the inner ear.  The inner ear consists of the cochlea, a snail shaped organ that contains the hearing organ, and an organ that controls balance 

There is a passageway that connects the middle ear to the upper part of the throat called the Eustachian tube. It is generally closed, but opens occasionally to replenish the air in the middle ear.  It also equalizes pressure in response to changes in air pressure in the environment.  When you have a cold the Eustachian tube may swell or become clogged with mucus and be unable to open and ventilate the middle ear.  This may allow fluid to accumulate behind the eardrum.

Bacteria entering the middle ear by way of the Eustachian tube may cause an infection and lead to more accumulation of fluid causing pressure on the eardrum and pain.  If the pressure is not relieved, the eardrum may eventually rupture allowing the fluid to drain.

Hearing loss from otitis media is usually temporary, but if left untreated, may lead to permanent hearing impairment.  Other serious complications can occasionally occur. 

Signs of otitis media in small children:

• Unusual irritability
• Difficulty sleeping
• Tugging or pulling at one or both ears
• Fever
• Fluid draining from the ear
• Loss of balance
• Unresponsiveness to quiet sounds or other signs of hearing difficulty such as sitting too close to the television or being inattentive   

A physician can diagnose otitis media by looking at the eardrum and the ear canal.  He/she may use an instrument to blow a puff of air onto the eardrum to test eardrum movement.  Fluid behind the eardrum does not allow the eardrum to move as easily as it would normally.

 Antibiotics are often prescribed to treat otitis media and a pain reliever may be needed to relieve discomfort. If antibiotics are prescribed, the full course of medication should be taken and a follow-up visit should be done to make sure the infections is cleared.