Ear Infections (Otitis Media)

Ear infections are common in children between the ages of 6 months and 3 years. Nearly 75% of children have at least one middle ear infection by the time they are 3 years old, and half of those children have three or more.

The team of pediatric otolaryngologists (also known as ear, nose and throat specialists, or ENTs) at University of Michigan C.S. Mott Children’s Hospital offers special expertise evaluating children who have recurring, chronic ear infections.  We offer a full range of diagnosis, treatment and support options, including hearing rehabilitation and speech therapy for children whose chronic ear infections have resulted in hearing loss and/or speech impairment. Our team includes pediatric otolaryngologists, audiologists and speech therapists, all of whom specialize exclusively in working with children. Learn more about our pediatric ear, nose and throat program.

What are ear infections?

The middle ear is an air-filled space located behind the eardrum. A small passage called the Eustachian tube connects the middle ear to the back of the nose. This tube helps equalize pressure between the air around you and the middle ear. Bacteria or viruses can enter the middle ear through the Eustachian tube and cause an infection. This often happens when a child has had a cold or other respiratory infection. The buildup of fluid causes pressure that pushes on the eardrum and may cause pain, and the child may experience a temporary decrease in hearing.

Any child can develop an ear infection, but a number of factors may increase your child’s risk of developing an ear infection: attending a group child-care facility, taking a bottle to bed, secondhand smoke exposure, craniofacial abnormalities, and absence of breastfeeding.

These factors are further complicated if the Eustachian tube does not work properly, possibly due to an immature Eustachian tube, inflamed adenoids, environmental allergies, or a cleft palate. 

Diagnosing ear infections

Symptoms of otitis media include:

  • ear pain
  • pulling or rubbing the ears
  • fever
  • fussiness or irritability
  • fluid draining from the ear
  • changes in appetite or sleeping patterns
  • hearing difficulties
  • loss of balance
  • congestion

Call your child’s primary care doctor if you think your child has an ear infection. He or she will perform a physical examination and look at your child's eardrums to determine if there is an infection present. If sufficient pressure exists, the ear drum may perforate or develop a hole, and yellow, green, or sometimes bloody drainage may occur. This usually relieves most of the acute pain. Often, the hole is not seen because it is too small or the drainage is covering it. The treatment is ear drops and possibly antibiotics. The ear drum should be examined once the drainage stops to be sure that the perforation has healed.

Treatment for ear infections

For most patients, the fluid will resolve over time and hearing will be restored. Many primary care providers will re-evaluate the child in six to eight weeks to determine if the middle ear fluid has resolved. In general antibiotics for this asymptomatic fluid are not needed.

Your doctor will determine whether antibiotics are needed, and advise you on how to treat your child for pain while the infection clears up. Read more about ear infection treatment guidelines on our blog.

If your child continues to have frequent ear infections that don’t clear up easily, your child's physician may recommend evaluation by an otolaryngologist (ENT) to see if ear tube surgery is warranted. This surgical procedure (sometimes called myringotomy or tympanostomy tube surgery) involves making a small opening in the eardrum to drain the fluid and relieve the pressure from the middle ear. A small tube is placed in the opening of the eardrum to allow air to enter the middle ear and to prevent fluid from accumulating. Tube placement can reduce the need for antibiotics by mouth, which helps lessen the risk of resistant bacteria and also decreases the risk of allergic reactions to the medications.

In most cases, the procedure takes about 10 to 15 minutes, and the total time spent in the hospital is a few hours. Very young children or those with other medical problems may stay longer.

The tiny hole in the eardrum from the tube usually results in improved hearing due to better drainage.

In most cases, surgery to remove ear tubes isn't necessary. The tubes are pushed out as the eardrum heals and generally fall out on their own,. If the tube remains in the eardrum beyond two to three years, however, your surgeon may recommend removing it under anesthesia to prevent a perforation in the eardrum or accumulation of debris around the tube.

Your child's doctor may also recommend the removal of the adenoids to reduce the inflammation around the Eustachian tube, particularly if your child has snoring and mouth breathing issues or is having surgery for a second set of ear tubes.

Hearing loss may occur in children who experience chronic ear infections. We offer a comprehensive hearing loss program to support families, including both diagnosis and treatment options.

Take the next step:

Schedule an appointment by calling us at 734-936-8051.