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Ear Infection

Kulak Enfeksiyonu

An ear infection, an infection that occurs in the space behind the eardrum, is a common reason for your child to see a doctor. Ear infections occur when bacteria or viruses infect and trap fluid behind the eardrum, causing pain and swelling in the eardrum. Treatments include antibiotics, pain relief medications, and the placement of ear tubes.


What is an ear infection?

The commonly used term “ear infection” is medically known as acute otitis media, or a sudden infection in the middle ear (the space behind the eardrum). Although ear infections are one of the most common reasons young children go to the doctor, anyone—children and adults alike—can get an ear infection.

In most cases, ear infections resolve on their own. Your doctor may recommend a medication to relieve pain. If the ear infection gets worse or does not improve, your doctor may prescribe an antibiotic. In children younger than two years of age, ear infections usually require an antibiotic.

It’s important to see your doctor if you or your child has ongoing pain or discomfort to make sure the ear infection is getting better. Hearing problems and other serious effects can occur with ongoing ear infections, frequent infections, and when fluid builds up behind the eardrum.

Where is the middle ear?

The middle ear is behind the eardrum and is also home to the sensitive bones that help with hearing. These bones are the hammer, anvil and stirrup. Let’s look at the entire structure and function of the ear to provide the bigger picture: 

The ear has three main parts: outer, middle and inner.

Other parts nearby

Who gets ear infection (otitis media) most?

Middle ear infection is the most common childhood illness (other than the common cold). Ear infections are most common in children between the ages of 3 months and 3 years and are common by age 8. Approximately 25% of all children have recurrent ear infections.

Adults can also get ear infections, but they are not as common as they are in children.

Risk factors for ear infections include:


What causes ear infection?

Ear infections are caused by bacteria and viruses. Most often, an ear infection begins after a cold or other respiratory infection. The bacteria or virus travels to the middle ear through the eustachian tube (there is one in each ear). This tube connects the middle ear to the back of the throat. Bacteria or viruses can also cause swelling of the eustachian tube. This swelling can cause the tube to become blocked, allowing fluids normally produced to accumulate in the middle ear instead of being drained.

The fact that the eustachian tube in children is shorter and less inclined than in adults further exacerbates the problem. This physical difference makes it easier for these tubes to become blocked and difficult to drain. The trapped fluid may become infected with a virus or bacteria and cause pain.

Since your doctor may use these terms, it is important that you have a basic understanding of them:

What are the symptoms of otitis media (middle ear infection)?

Ear infection symptoms include:


How is an ear infection diagnosed?

Ear Examination

Your doctor will look at your or your child’s ear using an instrument called an otoscope. A healthy eardrum will be pinkish gray and translucent (clear). If there is infection, the eardrum may become inflamed, swollen, or red.

Your doctor may also check fluid in the middle ear using a pneumatic otoscope, which blows a small amount of air into the eardrum. This should cause the eardrum to move back and forth. If there is fluid inside the ear, the eardrum does not move easily.

Another test, tympanometry, uses air pressure to check for fluid in the middle ear. This test does not test hearing. If necessary, if you or your child has long-term or frequent ear infections or fluid that does not drain from the middle ear, your doctor will order a hearing test performed by an audiologist to determine possible hearing loss.

Other controls

Your doctor will also check your throat and nasal passage for signs of upper respiratory tract infection and listen to your breathing.

Nonprescription acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®) can help relieve earache or fever. Pain-relieving ear drops may also be prescribed. These medications usually begin to reduce pain within a few hours. Your doctor will recommend pain medications for you or your child and provide additional instructions.

Never give aspirin to children. Aspirin can cause a life-threatening condition called Reye’s Syndrome.

Earaches hurt more before going to bed. Applying a warm compress to the outside of the ear can also relieve pain. (This is not recommended for babies.)

Ear tubes (tympanostomy tubes)

Sometimes ear infections may persist (chronic), recur frequently, or fluid in the middle ear may persist for months after the infection has cleared (otitis media with effusion). Most children have ear infections by age 5, and some children have frequent ear infections. Significant symptoms of an ear infection in a child may include pain inside the ear, a feeling of fullness in the ear, muffled hearing, fever, nausea, vomiting, diarrhea, crying, irritability, and pulling of the ears (especially in very young children). . If your child has had frequent ear infections (three ear infections in six months or four infections a year), ear infections that don’t get better with antibiotics, or   hearing loss due to fluid buildup behind the eardrum , you may be a candidate. for ear tubes. Ear tubes can provide immediate relief and are sometimes recommended for young children who are developing speech and language skills. You may be referred to an ear, nose and throat (ENT) specialist for this outpatient surgical procedure. Myringotomy with placement of an ear  tube. During the procedure, a small metal or plastic tube is inserted through a small incision (cut) in the eardrum. The tube allows air into the middle ear and allows fluid to drain. The procedure is very short – about 10 minutes – and this procedure has a low complication rate. This tube usually stays in place for six to 12 months. It usually goes away on its own, but it can also be removed by your doctor. The outer ear will need to be dry and free of dirty water such as lake water until the hole in the eardrum is completely healed and closed.

What are the harms of fluid accumulation in your ears or recurring or ongoing ear infections?

Most ear infections do not cause long-term problems, but when they do occur complications can include:


What can I do to prevent ear infections in myself and my child?

Here are some ways to reduce your or your child’s risk of ear infections:


What should I expect if I or my child has an ear infection?

Ear infections are common in children. Adults can take it too. Most ear infections are not serious. Your doctor will recommend over-the-counter medications to reduce pain and fever. Pain relief may begin several hours after taking the medication.

Your doctor may wait a few days before prescribing an antibiotic. Many infections go away on their own without the need for antibiotics. If you or your child takes an antibiotic, you should start to see improvement within two to three days.

If you or your child has ongoing or frequent infections, or if fluid remains in the middle ear and compromises hearing, ear tubes may be surgically placed in the eardrum to allow fluid to flow through the Eustachian tube as it normally should.

If you have any concerns or questions, never hesitate to contact your doctor.


When should I return to my doctor for a follow-up visit?

Your doctor will let you know when you should return for a follow-up visit. At this visit, your or your child’s eardrum will be examined to make sure the infection is gone. Your doctor may also want to test you or your child’s hearing.

Follow-up examinations are very important, especially if the infection has caused a hole in the eardrum.

When should I call the doctor about an ear infection?

Call your doctor immediately if:

Call your doctor during business hours if:

Why do children get ear infections so much more than adults? Does my child always get ear infections?

Children are more likely than adults to get ear infections because of:

Most children stop getting ear infections by age 8.

Do I need to cover my ears if I go out with an ear infection?

No, you don’t need to cover your ears when going out.

Can I swim if I have an ear infection?

There is no harm in swimming as long as there is no tear (perforation) in your eardrum or discharge from your ear.

Can I travel by plane or be at high altitudes if I have an ear infection?

Air travel or a trip to the mountains is safe, although temporary pain during takeoff and landing is possible when flying. Swallowing liquids, chewing gum during landing, or having the child suck on a pacifier will help relieve discomfort during air travel.

Are ear infections contagious?

No, ear infections are not contagious.

When can my child return to normal daily activities?

Children can return to school or nursery as soon as the fever subsides.

What are the other causes of earache?

Other causes of earache include:


How is an ear infection treated?

Treatment of ear infections depends on age, the severity of the infection, the nature of the infection (first-time infection, ongoing infection, or recurrent infection), and whether fluid remains in the middle ear for a long time.

Your doctor will recommend medications to relieve you or your child’s pain and fever. If the ear infection is mild, depending on the child’s age, your doctor may choose to wait a few days to see if the infection goes away on its own before prescribing an antibiotic.


If bacteria is thought to be the cause of the ear infection, antibiotics may be prescribed. Your doctor may want to wait up to three days before prescribing antibiotics to see if a mild infection clears up on its own as the child grows. If you or your child’s ear infection is severe, antibiotics may be started right away.

If your doctor prescribes an antibiotic, take it exactly as directed. You or your child will begin to feel better within a few days of starting treatment. Even if you feel better and your pain is gone, do not stop taking the medicine until you are told to stop. The infection may come back if you don’t take all the medications. If the antibiotic prescribed for your child is liquid, be sure to use a measuring spoon designed for liquid medications to ensure you give the correct amount.

A hole or tear in your eardrum due to a severe infection or an ongoing infection (chronic suppurative otitis media) is treated with antibiotic ear drops and sometimes using a suction device to remove fluids. Your doctor will give you specific instructions on what to do.

Pain medications