Otitis media is more commonly known as a middle ear infection. It involves inflammation and/or infection of the middle ear and is typically preceded by or associated with a viral upper respiratory tract infection. It is among the most common illnesses in children, affecting 75 percent of all boys and girls by their third birthday.

Middle ear infections begin when a cold, allergy or other condition causes inflammation and blockage of the eustachian tube, a narrow passageway that connects the back of the middle ear to the back of the nose and throat. This blockage leads to a buildup of fluid in the middle ear that becomes a breeding ground for trapped germs such as viruses and bacteria. The result is an infection that tends to be very painful and is often accompanied by symptoms such as fever, listlessness, hearing impairment and difficulty sleeping.

Children are at higher risk for ear infections than adults because their eustachian tubes are shorter and narrower, their adenoids (gland-like structures located in the back of the upper throat) are large enough to sometimes hamper the opening of their eustachian tubes, and their immune systems are not fully developed.

Diagnosis of otitis media begins with a physical examination and thorough medical history. The physician often uses an instrument called an otoscope to search for signs of eustachian tube blockage, such as air bubbles or fluid behind the eardrum. Other tests may include pneumatic otoscopy (visual examination of a patient’s eardrum) and tympanometry (a more precise test of a patient’s eardrum function).

In many cases, an ear infection will resolve on its own without the need for additional treatments. Ear infections resulting from bacteria can be treated with antibiotics. However, this is not always recommended, particularly when a child has mild symptoms. Overuse of antibiotics can create strains of antibiotic-resistant bacteria, and the medication may cause side effects in some children. Persistent fluid buildup in the middle ear is sometimes treated by inserting drainage tubes into an incision in the child’s eardrum.