Why It's Important to Detect Middle Ear Infections Early

Middle Ear Infection is the #1 Indication for Antibiotics and the #1 Reason for Surgery in Children

Middle ear infections, also known as otitis media, are the second most common disease in childhood after an upper respiratory infection (URI). Middle ear infections occur most often in children between 3 months to 3 years and are the most common reason parents bring their children for a doctor's visit. Nearly every child in America (93%) will suffer at least one middle ear infection severe enough to see a doctor, and most will suffer repeat occurrences, up to a dozen or more in childhood. These painful episodes are difficult for children, parents, and caregivers. In pediatric patients, middle ear infections are the most common indication for antibiotic therapy and surgery (tympanostomy tube insertion).

Middle ear infections frequently arise due to the presence of bacteria or viruses, which are commonly triggered by illnesses such as colds, influenza, or allergic reactions. These illnesses can cause congestion and swelling within the nasal passages, throat, and eustachian tubes— critical channels that play a vital role in maintaining proper ear pressure balance. When the tubes become blocked, they can trap fluid within the middle ear, leading to significant discomfort and pain. If this fluid persists for an extended period, it creates the ideal environment for an infection to flourish and develop.

There are three common types of middle ear infections:

1. Acute otitis media (AOM): The most common type of middle ear infection caused by a virus or bacteria. It comes on quickly and often causes pain, fever, and hearing loss. For AOM, the middle ear is filled with pus, and the pressure causes the eardrum to bulge outward. It usually lasts a few days to weeks. More than one-third of children experience six or more acute middle ear infections by 7 years of age.

2. Otitis media with effusion (OME): After the initial infection of AOM, non-infectious fluid may build up, causing hearing loss and a feeling of fullness in the ear. This can happen even without an infection, and antibiotics are not needed. It typically lasts four to six weeks. The fluid is not actively infected and these can be difficult to detect because it may not be painful or pain can be minimal.

3. Chronic otitis media: A recurring middle ear infection that doesn't fully go away. It can cause ongoing inflammation and fluid build-up and may result in a tear in the eardrum, leading to discharge. Chronic otitis media may also be called “glue ear”, because the middle ear fluid is thicker and more viscous, resembling mucous. It can cause long-term hearing loss due to its dense consistency.

Accurate diagnosis of acute otitis media in pediatric patients may be difficult as they may be unable to communicate their discomfort. However, if otitis media is left untreated, it can lead to various complications, including hearing loss, speech, education, and other developmental delays. Clinical studies show diagnostic error rates averaging 50 percent, particularly in the key differentiation of whether or not to prescribe an antibiotic. As a result, patients are often given ineffective treatment and are referred to specialists more often than necessary. By understanding the importance of early detection, parents and clinicians can take proactive steps to identify and address otitis media in its early stages, preventing potential complications such as hearing loss and speech delays. The OtoNexus ultrasound otoscope is the first ear check device that provides crucial information about the presence and type of infection within seconds so that clinicians may quickly provide precise, accurate treatment of middle ear infections.