Few pains are more excruciating to a young child than an earache. After the common cold, an ear infection is the most frequent childhood illness and three out of four children will experience an ear infection by their third birthday.
"When a child complains of an earache, it usually means he or she has otitis media, or a middle ear infection," says Dr. Dale Rice, the Chair of the USC Otolaryngology Department at USC. (An otolaryngologist is a head and neck surgeon).
The ear has three parts: the outer ear, middle ear and inner ear, Rice explains. The outer ear, which collects sound, includes the part outside the head and the ear canal. At the end of the ear canal is the eardrum, a small circle of tissue about the size of a fingertip. Behind the eardrum is the middle ear, which is normally filled with air. When the eardrum vibrates, tiny bones in the middle ear transmit the sound to the inner ear, where nerves relay sound signals to the brain.
"Middle ear infections are usually a complication of upper respiratory infection, such as a cold," Rice says. Bacteria travel up the Eustachian tube, a tiny tunnel that connects the back of the nose and throat to the middle ear. When the tube is blocked, fluid builds up in the middle ear, causing the ear to ache and swell. In children, this tube is shorter than in adults and allows germs to reach the ear more easily. Another reason children are more prone to earaches than adults is because their immune systems are not fully developed, Rice adds.
In babies and young children, symptoms of a middle ear infection include:
- Hearing problems
- Unusual irritability
- Tugging at ears
- Ear drainage
"Ear infections, like other infections, are essentially treated with antibiotics," Rice says.
Antibiotic drops may be prescribed if pus is leaking from the ear. If a child has a bulging eardrum and is in severe pain, a surgical incision may be made to the eardrum to release the pus.
Although rare, complications from untreated ear infections include:
- Eardrum rupture
- Infection of the inner ear (labyrinthitis), which causes dizziness and imbalance
- Infection of the skull behind the ear (mastoiditis)
- Infection of the membranes around the brain and spinal cord (meningitis)
- Scarring and thickening of the eardrum
- Facial paralysis
- Permanent hearing loss
"You can avoid middle ear infections by keeping your child away from cigarette smoke and playmates who are sick," says Rice. Studies have shown that children who breathe tobacco smoke have a higher risk of developing health problems, including ear infections.