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Ear infections are incredibly common in children, with up to 80% experiencing at least one ear infection by age 5. While they can often be treated with a simple course of antibiotics, it’s important to understand the different types of ear infections and when to consider possible surgery for children who experience them repeatedly.
It is important to note that swimmer’s ear (otitis externa) and a middle ear infection (otitis media) are two different conditions, though they can be confused with one another.
Swimmer’s ear is an infection of the outer ear canal and the skin inside it. This typically occurs when the environment of the ear canal is disrupted by outside factors such as water exposure or q‑tip use. Symptoms may include:
A middle ear infection is caused by a bacterial infection in the fluid trapped behind the eardrum. While ear pain is common in both conditions, a middle ear infection may also cause:
Middle ear infections can happen at any age, but they are especially common in young children. Some common contributing factors include:
During allergy season, a child’s sinuses and nasal passages can become inflamed, creating that familiar “stuffed‑up” feeling. Their eustachian tubes—which connect the ears and the nose—can also swell. When this happens, fluid can build up and harbor bacteria, leading to infection.
Dr. Jason Barnes, an otolaryngologist who practices at CEENTA’s Mooresville office, explains why ear infections are prevalent in children. “A child’s eustachian tubes are narrower and more horizontal than an adult’s, which makes fluid drainage more difficult. Because of this, ear infections are more common in very young children until their tubes mature and become wider and more vertical.”
Respiratory viruses can inflame the eustachian tubes and set the stage for a bacterial infection in fluid that accumulates in the middle ear. While ear infections themselves are not contagious, the viruses that contribute to them—like the flu and common cold—are. This makes ear infections more common during the colder months, especially in close-contact settings like schools or daycare.
A simple ear infection may clear on its own but is often treated with antibiotics. Ear infections that occur at least three times in six months or four times in one year are considered recurrent.
Common risk factors for recurring ear infections include:
Unfortunately, there are very few effective home treatments for a true middle ear infection. Doctors often recommend pain control with acetaminophen or ibuprofen. Watchful waiting may be appropriate in some cases, but many children will still require antibiotics to resolve the infection. Over‑the‑counter ear drops are not effective for treating middle ear infections.
Some ear infections will resolve on their own. However, if left untreated, an infection can lead to an eardrum rupture or, in more severe cases, spread to the adjacent mastoid bone or other important structures near the ear.
If your child’s ear infections are recurring, your physician may suggest ear tubes.
“Ear tubes are small cylinders placed through the eardrum to allow fluid to drain and prevent fluid buildup behind the eardrum,” says Dr. Barnes. “This procedure is performed under general anesthesia and typically takes about 15 minutes. Ear tubes usually remain in place for around a year and often fall out on their own.”
Children may be good candidates for ear tubes if they have:
Children who do not respond well to antibiotics or topical treatments may also benefit from ear tubes.
Looking to relieve your child’s ear pain? CEENTA’s board‑certified ENT physicians offer same‑day appointments to help treat recurrent ear infections with ease. To get started, schedule your child’s next ENT appointment with Dr. Barnes online or through myCEENTAchart.
This blog is for informational purposes only. For specific medical questions, please consult your doctor.
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