Middle Ear Infection

Middle ear infection is also known as acute otitis media or chronic otitis media.

Infection of the middle ear can occur when there is an accumulation of pus and mucus that sits behind the eardrum and blocks the Eustachian tubes. This can happen because of the presence of bacteria during or after a cold, allergy or upper respiratory infections.  This can cause earache, pain and swelling.

Middle ear infections are most common in children.

Fluid can also form in the middle ear and when this happens it is called 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 many weeks and even months.  When the fluid or discharge returns repeatedly or persists, it is then that we call it chronic otitis media or chronic middle ear infection.

This fluid can remain in the ear for up to three weeks following the infection.  If left untreated, chronic ear infections can lead to  consequences such as temporary hearing loss or even more seriously, permanent hearing loss or even meningitis.


Symptoms of Middle Ear Infection

Some of the most common symptoms of middle ear infection are:

  • Ear pain
  • Temperature
  • Irritability
  • Pulling or tugging at the ears
  • Difficulty sleeping


We will take a medical history and a physical examination. This is where we will look at the outer ear and eardrum using an instrument called an otoscope or the operating microscope.

We are looking for signs of redness, swelling, fluid and pus. The first step is to perform a tuning fork test, which can confirm the diagnosis of a middle ear infection or not. This can only be done on a child old enough to understand what is required from them.

A test called a tympanogram is also performed which determines whether the middle ear is operating properly. If an audiogram is required this is also performed. An audiogram is a hearing test.  All of this is offered at your time of appointment and can be done in our office.

Treatment of Middle Ear Infection

Mild cases of infection can be treated quickly with the use of paracetamol.

Some middle ear infections can lead to glue ear. This is when a thick fluid that is glue like in the middle ear causes deafness.  Treatment for glue ear can include antibiotics and a procedure to insert pressure equalising tubes, which are also called grommets, into the ear drums. This enables the middle and outer ear pressure to equalise.

Children with middle ear infection will have varying degrees of hearing loss. It may present as your child not being able to understand certain words and they may speak louder than normal. A child who has hearing loss from a middle ear infection will ear muffled sounds and may misunderstand speech.

This can be quite significant in a young child as they could permanently lose the ability to consistently understand speech in a noisy environment, such as a classroom, and this can lead to a delay in learning important speech and language skills. You may notice your child wanting to sit closer to the television. This is often a good indicator that your child may be hard of hearing.

Middle ear infections can be very common in young children and they are usually painful.

Generally, middle ear infections do not cause long term problems and most children will have outgrown them by the age of six.


For peace of mind, book an appointment with Dr Katzen if you have any concerns about your child’s hearing and health.