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Infections: Can be divided by location, including the external ear and canal, the middle ear, and the inner ear.

Middle Ear Infection ( otitis media) – inflammation located in the middle ear, usually occurs when a cold, allergy, or upper respiratory infection, and the presence of bacteria or viruses lead to the accumulation of pus and mucus behind the eardrum, blocking the Eustachian tube. This causes earache and swelling. Other symptoms include irritability, pain, ear tugging, fevers, ear drainage, and hearing loss. Untreated otitis media can result in serious infections of the brain, hearing loss, or problems with speech and language. Diagnosis is made by examination and assessment of eardrum movement. Occasionally an audiogram ( hearing test ) and tympanometry ( objective assessment of eardrum movement ) can be used. Treatments include pain control, antibiotics, and occasionally a surgical procedure to place ear tubes ( tympanostomy tubes )

Middle ear effusion ( otitis media with effusion ) – When fluid persists in the middle ear following an infection, the condition is known as “otitis media with effusion.” This occurs in a recovering ear infection or when one is about to occur. Fluid can remain in the ear for weeks to many months. Fluid can remain in the ear up to three weeks following the infection. If not treated, chronic ear infections have potentially serious consequences such as temporary or permanent hearing loss.

Middle ear infections in children– About 75 percent of children have at least one episode of otitis media by the time they are three years of age. All children with middle ear infection or fluid have some degree of hearing loss. The average hearing loss in ears with fluid is 24 decibels…equivalent to wearing ear plugs. (Twenty-four decibels is about the level of the very softest of whispers.) Thicker fluid can cause much more loss, up to 45 decibels (the range of conversational speech). Your child may have hearing loss if he or she is unable to understand certain words and speaks louder than normal. Essentially, a child experiencing hearing loss from middle ear infections will hear muffled sounds and misunderstand speech rather than incur a complete hearing loss. Even so, the consequences can be significant – the young patient could permanently lose the ability to consistently understand speech in a noisy environment (such as a classroom) leading to a delay in learning important speech and language skills.

Long-term/persistent ear infections ( Chronic otitis media ) – Sometimes patients develop multiple ear infections and in fact the infections never completely clear, and the ear is said to have chronic otitis media Often this also involves a hole the eardrum and persistent fluid drainage/discharge out of the ear. Usually there is not a lot of pain associated with this. Areas of bone behind the ear can also become infected and contribute to the infection. Over the long-term, there are risks of severe complications if the infection spreads to the neck, brain, or inner ear. This often persists despite antibiotics, and in these cases, surgery can be performed to clear away the areas of infection and repair the ear drum. The goal of surgery is to provide a dry and safe ear.

Preventing Ear Infections: Cold and allergy medications do not appear to prevent otitis media. And, currently, there is no vaccine that can prevent the disease. However, it is important to consult your health care provider and make sure your child’s vaccinations are up-to-date. There are certain factors that seem to increase the chances of otitis media developing in some children. These include living in a home where cigarettes are smoked, nursing with a bottle while lying down.