Children with ear infections sometimes experience additional medical problems. Some of these conditions may accompany ear infections, whereas others result from infections that are left untreated. These complications include:

• Temporary hearing loss. Fluid trapped in the middle ear or ear canal can impair sound transmission, causing temporary hearing loss. Most children experience some temporary hearing loss during the course of an ear infection. Hearing generally returns after the fluid clears.
  
  
• Speech impairment. Hearing loss as the result of ear infections may impair or delay development of speech in young children.
  
  
• Ruptured (perforated) eardrum. Occurs when the eardrum tears due to the pressure of fluid within the middle ear. After rupture, fluid will drain out of the ear canal, relieving pressure and pain in the middle ear. Surgery may be necessary to repair the tear, although ruptures usually heal on their own. Ruptures are rare, and hearing is not usually impaired.
  
  
• Additional ear infections. Untreated middle ear infections can rupture an eardrum, resulting in the leakage of pus into the ear canal and causing an infection of the outer ear. In addition, untreated outer ear infections can result in recurring infections.
  
  
• Cellulitis. An infection of the skin surrounding the external ear. Outer ear infections that are untreated or do not respond to treatment may recur and lead to cellulitis.
  
  
• Cholesteatoma. Buildup of cellular debris in the middle ear. This is usually the result of chronic ear infections and hearing loss. It may cause damage to structures within the middle ear.
  
  
• Structural damage inside the ear. The small bones of the middle ear and other structures in the ear may become damaged if a middle ear infection is left untreated.
  
  
• Permanent hearing loss. This can occur once there is structural damage to the middle ear. It can also occur with inner ear infections.
  
  
• Acute mastoiditis. Occurs when an ear infection spreads to the mastoid bone of the skull, located behind the ears. This complication is uncommon, and is usually the result of an untreated middle ear infection.

Ear infections can sometimes result from ear piercing. Piercing a child’s ears may lead to infection of the exterior ear (auricle). Bacteria or viruses that cause infection may enter at the site of the piercing via different means. Common reasons for infection include:

• Use of unsterile equipment or jewelry.
  
  
• Piercing an area other than the earlobe. Piercing the cartilage of the ear (rather than the earlobe) can cause infection due to fewer blood vessels in the area, which can trap and foster bacteria growth. Ear cartilage piercings also take longer to heal.
  
  
• Frequent handling of pierced ears with dirty hands.
  
  
• Wearing earrings that are too tight (or posts too short). This prevents air from passing through the hole of the piercing, restricting blood flow and increasing the risk of infection.
  
  
• Scratches on the ear from jewelry.
  
  
• Complication of allergies. Some jewelry worn in the ears may contain nickel. An allergic reaction to nickel can lead to infection in the area.