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What is otitis media and ear infection?

Otitis media refers to inflammation of the middle earWhen an abrupt infection occurs, the condition is called “acute otitis media”This condition occurs when a coldallergyvirusor the presence of bacteria leads to the accumulation of pus and mucus behind the eardrumthus blocking the eustachian tubeThis can cause earache and fever.

When fluid sits in the middle ear for weeksthe condition is known as “otitis media with effusion.” This condition occurs in a recovering ear infectionFluid can remain in the ear for weeks to many monthsIf not treatedchronic ear infections have potentially serious consequencessuch as temporary hearing loss.

Why do children have more ear infections than adults?

To understand earaches and ear infections, you must first know about the eustachian tubeThe eustachian tube is a narrow channel connecting the inside of the ear to the back of the throatjust above the soft palate and uvulaThe tube allows drainage of fluid from the middle earpreventing fluid from building up and bursting the thin ear drumIn a healthy earthe fluid drains down the tubeassisted by tiny hair cellsand is swallowed.

The tube also maintains middle ear pressure equal to the air outside of the earenabling free eardrum movementMost of the timethe tube is collapsed in order to prevent germs residing in the nose and mouth from entering the middle earInfection occurs when the eustachian tube fails to do its jobWhen the tube becomes partially blockedfluid accumulates in the middle eartrapping already present bacteria which then multiply.

Children have Eustachian tubes that are shortermore horizontal, and straighter than those of adultsThese factors make the journey for the bacteria quick and relatively easyThey also make it harder for the ears to clear the fluid since it cannot drain with the help of gravityA child’s tube is also floppier, with a smaller opening that easily clogs.

How does otitis media affect hearing?

Most people with a middle ear infection or fluid have some degree of hearing lossThe average hearing loss in ears with fluid is 24 decibelsequivalent to wearing ear plugs (twenty-four decibels is about the level of the very softest of whispers)Thicker fluid can cause a more severe loss of up to 45 decibels (the range of conversational speech).

You should suspect hearing loss if one is unable to understand certain words and speaks louder than normal.

Conductive hearing loss is a form of hearing impairment where the transmission of sound from the environment to the inner ear is impairedusually from an abnormality of the external auditory canal or middle earThis form of hearing loss can be temporary or permanentUntreated chronic ear infections can lead to conductive hearing lossIf fluid is filling the middle earhearing loss can be treated by draining the middle ear and inserting a tympanostomy tube.

Sensorineural hearing loss is the other form of lossThis type of hearing loss is due to abnormalities of the inner ear or the auditory division of the 8th cranial nerveHistoricallythis condition can occur at all ages and is usually permanent.

When should a hearing test be performed?

A hearing test should be performed for children who have frequent ear infectionshearing loss that lasts more than six weeksor fluid in the middle ear for more than three monthsThere are a wide range of medical devices now available to test a child’s hearingeustachian tube functionand flexibility of the ear drumThese devices include the otoscopytympanometerand audiometer.

Reasons for Hearing Loss

Children and adults can incur temporary hearing loss for other reasons than chronic middle ear infection and eustachian tube dysfunction. Reasons for hearing loss include:

  • Cerumen impaction (compressed earwax).
  • Otitis externa: Inflammation of the external auditory canalalso called “swimmer’s ear”.
  • Cholesteatoma: A mass of horn shaped squamous cell epithelium and cholesterol in the middle ear usually resulting from chronic otitis media.
  • Otosclerosis: This is a disease of the otic capsule (bony labyrinth) in the earThe condition is prevalent primarily in adults and characterized by the formation of soft vascular bone leading to progressive conductive hearing lossIt occurs due to fixation of the stapes (bones in the ear)Sensorineural hearing loss may result because of involvement of the cochlear duct.
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