Otitis Media: diagnosis and treatment

Middle ear inflammation

A temperature and sickness feeling can be a result from Otitis which can impact the sufferer's day-to-day life. The infection can cause discomfort along with impacting the hearing condition.

Otitis Media is an inflammation or infection of the middle ear estimated to affect at least one in four young people before they reach their teenage years. Approximately 75% of cases occur in children under the age of ten. Infants between six and 15 months old are the most commonly affected, but as an adult you can also suffer from Otitis Media. Most cases pass within a few days without any need to consult your local GP, but if you or your child suffer from any other underlying health conditions or see no signs of improvement within a week, we highly recommend you contact your local GP for further medical advice.


If you or your child are suffering from Otitis Media, you may notice some of the following warning signs:

  • Pulling, tugging or rubbing of the ear
  • Feverish temperature
  • Lack of appetite
  • Restlessness when trying to sleep
  • Irritability
  • A lack of response to quiet sounds
  • Vomiting and/or diarrhoea
  • Earache
  • Runny nose
  • Loss of balance

In some cases, you may find you develop a hole in your eardrum, this is known as a perforation. This allows pus to run out of the ear, relieving any earache symptoms.

Causes and triggers

Most middle ear infections are caused by a bacterial infection that spreads into the middle ear, often as a result of mucus build up from a cold or flu. This mucus gets trapped in the middle ear, causing the Eustachian tube - responsible for regulating air pressure in the middle ear - to become swollen. The Eustachian tube can also be blocked by an enlarged adenoid, the soft tissue at the back of your nose. If the adenoid causes persistent ear infections, it can be permanently removed.

Due to children's Eustachian tubes being smaller compared to you as an adult, they will be more prone to swelling of the adenoids, and are more susceptible to Otitis Media.

With this mind, several factors may trigger the condition:

  • Frequent nose or throat infections
  • Attending a nursery where infection exposure is likely to be higher
  • Exposure to tobacco smoke (passive smoking)
  • Feeding your children when they're flat on their back
  • Having a cleft palate
  • Having Down's syndrome


If you suspect that you or your child has Otitis Media, it can normally be identified using an otoscope, a medical device that has a magnifying glass attached to one end so your GP can look inside your ear. Your local GP will also be able to look for a bulging ear drum, an unusual colour or any perforations in the eardrum.

When the infection has been diagnosed, you may find that you are simply asked to take antibiotics and painkillers. Antibiotics will normally only be considered if you or your child has more severe symptoms such as earache and/or ear discharge.

If you suspect that you or your child has Otitis Media, always consult a medical professional in the first instance. For an overview of ear infections or to learn more about other ear conditions, click hereOtitis ExternaMastoiditis or Labyrinthitis pages. 

How do you diagnose otitis media?

The ENT doctor can diagnose an otitis media with an otoscopy. With the help of an otoscope, the doctor can determine changes in the external auditory canal and the eardrum. In addition, the ENT doctor pays attention to redness or swelling, as well as secretions that have accumulated in the ear canal. 

With an otoscopy, the ENT doctor can ultimately determine whether it is an otitis media. This is shown by severe reddening, swelling and bulging of the eardrum. There is no light reflex and a spontaneous perforation of the eardrum causes secretion to enter the external auditory canal.

What to do if you have otitis media

If you have symptoms of otitis media, it is advisable to seek medical advice in order to avoid a chronic course. It is also not advisable to go to work with this ear infection.

Rest is essential with otitis media. Sport is therefore taboo during the entire course of the disease in order to prevent the pathogens from spreading throughout the body. If you want to fly with otitis media , you should know that the affected ears can no longer compensate for the changed pressure conditions in the air, which can lead to severe pain and ear pressure. This is especially true for children.

If an otitis media keeps coming back, inserting a ventilation tube may help to keep the middle ear ventilated. This requires a small incision in the eardrum so that the tube can be inserted. 

Is otitis media contagious?

Since otitis media primarily affects children, parents wonder whether this ear infection is contagious. The good news is that otitis media is usually not contagious. However, if it is a concomitant symptom of a respiratory tract infection, the possibility of the pathogen being transmitted to other people cannot be excluded. 

Otitis media in children and babies

In many cases, otitis media affects babies and children between the ages of six months and six years. In young children, the disease is not always recognized immediately, because the typical signs of otitis media are often missing. Symptoms in a baby are more likely to be restless sleep or increased crying. Because it is often caused by viruses, antibiotics are not always effective. Therefore, the doctor usually prescribes mainly pain relievers and decongestants for otitis media in children and infants.

It is important to make sure that the dosage is appropriate for children. Otitis media in babies and children usually heals in a few days without consequences, however, it is advisable to consult a doctor.

A potential consequence: mastoiditis

If otitis media isn't treated, or isn't treated properly, a bacterial infection can develop. This is how mastoiditis develops. Infection leads to severe inflammation of the mastoid process of the temporal bone. This inflammation needs to be treated as soon as possible to prevent worse complications.

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