Acute Otitis Media: Symptoms, Causes, Risk Factors, Diagnosis, Treatment, Outlook and Prevention

Known by its acronym as AOM, it is a painful type of ear infection. It occurs when the area behind the eardrum called the middle ear becomes inflamed and infected.

The following behaviors in children often mean they have AOM:

  • Attacks of irritability and intense crying (in babies).
  • Holding on to the ear while wincing (in young children).
  • Complain of a pain in the ear (in older children).

What are the symptoms of acute otitis media?

Babies and children may have one or more of the following symptoms:

  • Crying.
  • Irritability.
  • Insomnia .
  • Pull the ears.
  • Earache.
  • Headache.
  • Neck Pain.
  • Feeling of fullness in the ear.
  • Drainage of fluid from the ear.
  • Fever.
  • Vomiting
  • Diarrhea.
  • Lack of balance
  • Hearing loss.

What causes it?

The Eustachian tube is the tube that runs from the middle of the ear to the back of the throat. An AOM occurs when the Eustachian tube becomes swollen or blocked and traps fluid in the middle ear. Trapped fluid can become infected.

In young children, the Eustachian tube is shorter and horizontal than in older children and adults. This makes it more likely to get infected . The Eustachian tube can become swollen or blocked for several reasons:

  • Allergies
  • A cold.
  • Gripe.
  • Sinus infection
  • Infected or enlarged adenoids.
  • Cigarette smoke.
  • Drink while lying down (in babies).

Who is at risk for acute otitis media?

Risk factors for AOM include:

  • Be between 6 and 36 months of age.
  • Use a pacifier.
  • Attend daycare.
  • Being bottle-fed instead of being breastfed (in babies).
  • Being exposed to high levels of air pollution.
  • Experience changes in altitude.
  • Experiencing changes in the weather.
  • Being in cold weather.
  • Having had a recent cold, flu, sinusitis, or ear infection .
  • Genetics also play an important role in increasing the risk of AOM.

How is it diagnosed?

Your doctor may use one or more of the following methods to diagnose AOM:

  • Otoscope: The doctor uses an instrument called an otoscope to look at the ear for redness, swelling, blood, pus, air bubbles, fluid in the middle ear, or perforation of the eardrum.
  • Tympanometry : During a tympanometry test, the doctor uses a small instrument to measure the air pressure in the ear to determine if the eardrum may rupture.
  • Reflectometry: During a reflectometry test, the doctor uses a small instrument that makes a sound near the ear. The doctor can determine if there is fluid in the ear by listening to the sound reflected from the ear.
  • Hearing test: Your doctor can perform a hearing test to determine if there is hearing loss.

How is acute otitis media treated?

Most AOM infections resolve without antibiotic treatment.

Home treatment and pain medications are generally recommended before antibiotics are tried to avoid overuse and reduce the risk of adverse reactions to them. Treatments for AOM include:

Home Care: Your doctor may suggest the following home care treatments to relieve pain while you wait for the AOM infection to clear up. These are:

  • Apply a warm, damp cloth to the infected ear
  • Using over-the-counter ear drops to relieve pain
  • Taking over-the-counter pain relievers such as ibuprofen (Advil, Motrin) and acetaminophen (Tylenol)

Medication: Your doctor may also prescribe pain relief drops and other pain relievers. Your doctor may prescribe antibiotics if your symptoms don’t go away after a few days of home treatment.

Surgery: Your doctor may recommend surgery if the infection does not respond to treatment or if there are recurring ear infections. Surgery options for AOM include:

  • Adenoid removal: Your doctor may recommend that adenoids be surgically removed if they are enlarged or infected and if there are recurring ear infections.
  • Ear tubes:  Your doctor may suggest a surgical procedure to insert small tubes into the ear. The tubes allow air and fluid to drain from the middle ear.

What is the long-term outlook?

AOM infections usually get better without complications, but the infection can reoccur. Temporary hearing loss may also be experienced for a short time. But hearing should return quickly after treatment.

Sometimes AOM infections can cause:

  • Recurring ear infections.
  • Adenoides agrandadas.
  • Enlarged tonsils.
  • Rupture of the eardrum.
  • Cholesteatoma (growth in the middle ear).
  • Speech delays (in children who have recurrent otitis media infections).
  • In rare cases, an infection in the mastoid bone in the skull (mastoiditis) or an infection in the brain (meningitis) can occur.

How to prevent acute otitis media?

You can reduce the chances of your child having AOM by doing the following:

  • Wash hands and toys frequently to reduce the chances of getting a cold or other respiratory infection.
  • Avoid cigarette smoke.
  • Get vaccinations against seasonal and pneumococcal flu.
  • Breastfeed infants instead of bottle feeding, and if possible avoid giving your baby a pacifier.