My Ear Hurts!

By Kathleen Stahl

An ear infection—or otitis media—is one of the most common reasons sick children visit their doctor. Most infants will have at least one ear infection before their first birthday.​

InnerEar
​Ear infections commonly occur after a viral infection causes fluid to accumulate in the middle ear, which is the space behind the eardrum that 
houses the small bones responsible for conducting sound. If this fluid becomes infected, increasing pressure on the eardrum can result in severe pain.

Symptoms of Ear Infections

Symptoms of an ear infection include pain, fever above 100.4 degrees
Fahrenheit, pulling at the ear, irritability, difficulty sleeping, temporarily decreased hearing, decreased activity, poor appetite, and occasionally vomiting or diarrhea. If you are concerned your child has an ear infection, he or she should be evaluated by a medical provider. Although the exam
is not painful, your healthcare provider may have difficulty clearly visualizing the eardrum – especially if your child is not feeling well and is uncooperative.

Treatment for Ear Infections

There are different treatment options for ear infections including antibiotics, 
pain medication, observation or a combination of all of these options.
Not all ear infections need to be treated with antibiotics and the decision to use antibiotics should be made with your healthcare provider. Children less than 2 years old with high fever or infection in both ears are normally treated with antibiotics. Children older than 2 years old with a mild fever and pain that is easily managed with Tylenol and Motrin can be observed during 24 – 48 hours to see if their symptoms improve without antibiotics. When choosing to observe a child with an ear infection, you

The Role of the Eustachian Tube and Adenoid

The eustachian tube runs from the middle ear, the space behind the eardrum, to the back of the throat behind the nose. The tube helps to regulate air pressure in the iddle ear and drain normally occurring 
fluid from the middle ear. The eustachian tube can become swollen and congested with upper respiratory infections causing excess fluid to accumulate in the middle ear. In young children, the angle of
the eustachian tube does not always allow fluid to drain adequately, and the
accumulated fluid can become infected with a virus or bacteria. 

The adenoid is a pad of tonsillar tissue in the back of the nose near the opening of the eustachian tube. Inflammation of the adenoid can contribute to swelling and congestion of the eustachian tube, making it difficult for fluid to drain from the middle ear. The resulting accumulation of fluid can become
infected.

Ear Tubes Can Help

Ear ventilation tubes, also called tympanostomy tubes, are small plastic 
or metal tubes surgically inserted into the eardrums allowing fluid to drain
from the middle ear into the ear canal. Ear tubes are sometimes recommended for children who have three to four ear infections in six months, children with chronic middle ear infections or noninfected fluid that does not drain over a three to four month period. Ear tubes will normally 
fall out within one to two years, and the hole left by the tube will normally heal shut. Children with ear tubestypically have fewer ear infections the
year following tube placement. If an ear infection occurs, it is often less painful. Children with ear tubes will typically experience a return of their hearing as the fluid drains. 

Ear tube placement is a relatively safe procedure with a low risk of serious complications. Risks include: the tube doesn’t fall out on its own; the hole that is made by the tube does not heal; persistent drainage; blocked tube from dried blood or mucus; scarring of the eardrum; the tube falling out too soon; and recurrent infections. 

Talk with your child’s healthcare providerfor more information on ear tubes. To find an ear, nose, and throat specialist near you, we invite you to visit the index at the back of this publication or IntermountainMedicalGroup.org.