Hi, this is Cathy with Level Up RN. In this episode of Ask a Nurse, I'll be answering your questions about middle ear infections such as what causes a middle ear infection and what are the symptoms of a middle ear infection and how is a middle ear infection treated? The fancy name for a middle ear infection is otitis media, and this is a very common infection in children. So a middle ear infection is different from an infection of the outer ear canal, which is often referred to as swimmer's ear. So a middle ear infection can be caused by a bacteria or a virus, and it typically occurs when a respiratory illness such as a cold causes congestion and inflammation of the nose, throat, and Eustachian tube, which connects the middle ear to the back of the throat. So when the Eustachian tube becomes inflamed and swells, it creates an obstruction that prevents fluid from leaving the middle ear, and that trapped fluid allows for microbial growth. Young children are at much higher risk for middle ear infections. This is partly because their Eustachian tubes are much shorter, which makes it easier for bacteria or viruses to get into the middle ear. Their Eustachian tubes are also more narrow, which makes it more likely for them to become blocked. And then adenoids, which are glands that sit behind the nasal cavity, are bigger in children, and this can cause an obstruction of the Eustachian tube as well. Other factors that increase the risk for a middle ear infection include exposure to cigarette smoke as well as daycare attendance because any time children are around a bunch of other kiddos, then they have increased exposure to illnesses such as colds, which can lead to a middle ear infection. In addition, formula-fed babies are more likely to get otitis media than babies who are breastfed because breastfeeding provides antibodies that help babies to fight off infections.
Symptoms of a middle ear infection include drainage from the affected ear, fever, increased crying, and irritability, as well as pulling on the affected ear. It can also cause issues with sleep as well as hearing impairment, and it can also lead to poor appetite because chewing and swallowing can cause more pain. A middle ear infection can be diagnosed by your provider using an otoscope. So normally, the eardrum is a nice pearly gray color, but with a middle ear infection, it will appear red and swollen upon examination. In terms of treatment, a mild ear infection will sometimes resolve on its own, so your provider may want to wait a couple days before prescribing antibiotics. However, for a moderate or severe ear infection, antibiotics will be prescribed. In addition, pain-relieving medications such as acetaminophen, which is Tylenol, ibuprofen, or pain-relieving eardrops may be recommended by your provider. As a reminder, aspirin should not be used in children due to the risk of Reye's syndrome, which is a very serious life-threatening illness. If your child has reoccurring middle ear infections or complications such as hearing loss associated with persistent fluid buildup in the middle ear, then your provider may recommend a myringotomy. This is a very short outpatient surgical procedure to place tubes in the ears. It takes about 10 minutes, and both of my children required this procedure due to recurrent middle ear infections, and they were in and out in no time at all. So during this procedure, a very tiny incision is created in the eardrum, and this allows fluid to drain out of the ear and relieves pressure in the middle ear. Then a very tiny tube is placed in that opening to help prevent fluid from accumulating in the middle ear again. So tubes usually stay in for about 6 to 12 months and typically fall out on their own.
If you suspect that your child might have an ear infection, it's important to take them to be seen by your provider because untreated ear infections can lead to complications such as hearing loss and speech delays. It's also important to make sure that you keep your child's vaccinations up-to-date because vaccines can help prevent illnesses that can lead to an ear infection. All right. That's it for this episode of Ask a Nurse. If you found this video helpful, definitely give it a thumbs up. And if you have a health-related question or topic you'd like me to cover in a future episode, then definitely leave that in the comments. Stay informed and stay well.
