Ear Infection (Otitis Media) Treatment in Indore

Otitis media is a general term that describes inflammation or infection of the middle ear, the air-filled space behind the eardrum (tympanic membrane). It occurs most frequently in infants and young children because of immaturity of the Eustachian tube and the immune system, but it can occur at any age.

1. Anatomy Relevant to Otitis Media

The middle ear comprises:

Ossicles (small bones: malleus, incus, stapes), which transmit sound

Eustachian tube: connects the middle ear with the back of the throat (nasopharynx) for equalising pressure and draining fluid

In young children, the Eustachian tube is shorter, more horizontal, and more easily blocked, increasing the risk of infection.

2. What Causes Otitis Media?

Otitis media usually develops when fluid builds up behind the eardrum and becomes infected.

Common causes

Viral infections

Cold, flu, RSV, rhinovirus, adenovirus, etc.

Fluid is trapped due to the swelling of the eustachian tube by a virus.

Bacterial infections

Streptococcus pneumoniae

Haemophilus influenzae

Moraxella catarrhalis

Eustachian tube dysfunction

Allergies

Upper respiratory infections

Adenoid enlargement, especially in children

3. Types of Otitis Media

1. Acute Otitis Media (AOM)

Acute onset

Middle ear infection with rapid inflammation, pain, and often fever

Fluid may be infected (purulent)

2. Otitis Media with Effusion (OME)

Also known as serous otitis media or “glue ear”

Fluid remains behind the eardrum without active infection

Common after AOM or viral colds

Often causes hearing difficulties rather than pain

3. Chronic Otitis Media

chronic or recurrent inflammation

May include perforation of the eardrum, persistent drainage, or cholesteatoma formation

4. Signs and Symptoms

Common symptoms of AOM

Otalgia (ear pain)-often severe

Fever

Hearing loss or muffled hearing

Irritability (in young children)

Ear drainage (if the eardrum ruptures)

Fullness or pressure in the ear

Sleep disturbance

Reduced appetite-sucking/swallowing increases pressure and pain

Signs in infants

Tugging or pulling at the ear

Crying more than usual

Difficulty feeding

5. The Development Mechanism of Otitis Media

Nasal congestion and inflammation are caused by a cold, flu, or allergy.

The Eustachian tube swells and cannot ventilate the middle ear.

Air is absorbed → negative pressure forms → fluid is drawn into the middle ear.

This trapped fluid gets infected by bacteria or viruses.

Pus fills the middle ear → red, bulging, painful eardrum.

In more extreme instances, pressure can force the eardrum to perforate, allowing drainage and reducing pain.

6. Risk Factors

Age (6 months–3 years highest)

Bottle-feeding (vs. breastfeeding)

Use of pacifiers

Daycare attendance- More viral exposure

Secondhand smoke exposure

Allergies

Large adenoids

Family history of frequent ear infections

7. Diagnosis (What Clinicians Look For)

A healthcare provider is examining the ear with an otoscope.

Key findings:

Bulging, red, or opaque eardrum

Reduced mobility of the eardrum

tested with pneumatic otoscopy

Presence of fluid behind the eardrum.

8. Treatment Overview (Educational Only—Not Individual Medical Advice)

Treatment varies depending on the type and severity.

Acute Otitis Media (AOM)

Pain control: acetaminophen or ibuprofen (age-appropriate dosage)

Observation for 24–48 hours in many children and adults who have mild symptoms

Antibiotics may be prescribed if:

Symptoms are moderate-severe

symptoms persist >48 hours

high fever

child is very young

recurrent infections

It is frequently the agent of first choice unless allergies or resistance patterns so indicate.

OME - Otitis Media with Effusion

Usually no antibiotics

Watchful waiting for 3 months

Audiological examinations in chronic cases

Chronic Otitis Media

ENT evaluation

Possible long-term antibiotics, surgery, or tympanostomy tubes

9. Possible Complications

Rare but important:

Hearing impairment, typically temporary

Speech delay in chronic OME in children

Tympanic membrane perforation

Mastoiditis (infection spreading to the mastoid bone)

Cholesteatoma abnormal skin growth in the middle ear

Intracranial infections (very rare)

The 10. Prevention

Breastfeeding reduces ear infections.

Avoiding secondhand smoke

Vaccinations, including the flu vaccine and the pneumococcal vaccine. Good hand hygiene, limiting pacifier use after 6 months, and managing allergies