Otitis media is infection of the middle ear, behind the eardrum. Germs that cause the infection reach the middle ear through the eustachian tube. In children, eustachian tube is shorter than in adults and it is easier for the germs to reach the middle ear. Therefore, otitis media is more common in children. Infection in the middle ear causes accumulation of an inflammatory fluid causing hearing loss and pain. Appropriate antibiotic treatment kills bacteria causing otitis media, resolves fluid in the middle ear, and hearing loss. 

Where is the middle ear?

The ear has three parts: 1) outer ear, 2) middle ear, and 3) inner ear. The outer ear is formed by the auricle and ear canal. The ear canal ends with the eardrum which is a thin structure which vibrates with sound. The middle ear is a cavity containing air that is located behind the eardrum. The air is transported to the middle ear through a narrow tube from the back of the nose and this tube equalizes pressure in the middle ear with the atmospheric pressure. The vibrations generated by the sound on the eardrum are transmitted to the inner ear through three small ossicles (anvil, stirrup, hammer). The inner ear converts and transmits the sound to the brain through nerves.

Otitis media is one of the common diseases of childhood. Statistics show that two thirds of children up to three years of age have at least one episode of otitis media.


Symptoms of otitis media

  • Earache
  • Fever
  • Hearing loss
  • Restlessness
  • Loss of appetite

These symptoms may proceed or accompny signs of an upper respiratory tract infection, usually common cold. 

In severe otitis media, ear drum may be ruptured and a discharge may be seen in the ear canal.  In this case, ear pain and fever decrease dramatically. The hole in the eardrum usually closes by itself within a couple of days.

How to prevent otitis media

Bottle fed while lying should be awoided in infants. Common cold should be managed properly in elder childen to decrease the freuency of otitis media.

Is it contagious?

No. But, common cold which is the cause of otitis media is contagious.

How is it treated?

Otitis media is treated with antibiotics and medications to relieve eustachian tube swelling, for 10 to 14 days. Rarely, surgical drainage of pus from the eardrum may be necessary. This procedure is called a “myringotomy” and is performed under general anesthesia.

Self care

Children with signs of otitis media should be examined by a physician initially. Pain killers may help to releive ear ache and fever. Children with draining ears should not swim and take shower without protection of ear plugs. 


The recovery time of otitis media may vary. It may heal spontaneously within a couple of days, or fluid within the middle ear may persist for 2 weeks to two months. Presence of fluid may cause temporary and mild hearing loss.

Is there a risk of permanent hearing loss?

When treated properly, the risk for permanent hearing loss due to otitis media is very low.

When to see a doctor?

Otitis media may result in chronicity and serious problems when left untreated. Children with signs of otitis media should be examined by a physician. Your doctor will also look for other causes of ear ache such as tooth eruption, foreign body, trauma of the ear canal with Q-tips, ear wax etc. Since the ear canal and the eardrum can only be evaluated by a physician, this examination is essential to identify the cause of signs and plan the treatment.