Acute otitis media

Acute otitis media

Acute otitis media (AOM) is a painful type of ear infection. It occurs when the area behind the eardrum called the middle ear becomes inflamed and infected.

The following behaviors in children often mean they have AOM:

  • fits of fussiness and intense crying (in infants)
  • clutching the ear while wincing in pain (in toddlers)
  • complaining about a pain in the ear (in older children)


What are the symptoms of acute otitis media?

Infants and children may have one or more of the following symptoms:

  • crying
  • irritability
  • sleeplessness
  • pulling on the ears
  • ear pain
  • a headache
  • neck pain
  • a feeling of fullness in the ear
  • fluid drainage from the ear
  • a fever
  • vomiting
  • diarrhea
  • irritability
  • a lack of balance
  • hearing loss


What causes acute otitis media?

The eustachian tube is the tube that runs from the middle of the ear to the back of the throat. An AOM occurs when your child’s eustachian tube becomes swollen or blocked and traps fluid in the middle ear. The trapped fluid can become infected. In young children, the eustachian tube is shorter and more horizontal than it is in older children and adults. This makes it more likely to become infected.

The eustachian tube can become swollen or blocked for several reasons:

  • allergies
  • a cold
  • the flu
  • a sinus infection
  • infected or enlarged adenoids
  • cigarette smoke
  • drinking while laying down (in infants)



Who’s at risk for acute otitis media?

The risk factors for AOM include:

  • being between 6 and 36 months old
  • using a pacifier
  • attending daycare
  • being bottle fed instead of breastfed (in infants)
  • drinking while laying down (in infants)
  • being exposed to cigarette smoke
  • being exposed to high levels of air pollution
  • experiencing changes in altitude
  • experiencing changes in climate
  • being in a cold climate
  • having had a recent cold, flu, sinus, or ear infection

Genetics also plays a role in increasing your child’s risk of AOM.


How is acute otitis media diagnosed?

Your child’s doctor may use one or more of the following methods to diagnose AOM:


Your child’s doctor uses an instrument called an otoscope to look into your child’s ear and detect:

  • redness
  • swelling
  • blood
  • pus
  • air bubbles
  • fluid in the middle ear
  • perforation of the eardrum


During a tympanometry test, your child’s doctor uses a small instrument to measure the air pressure in your child’s ear and determine if the eardrum is ruptured.


During a reflectometry test, your child’s doctor uses a small instrument that makes a sound near your child’s ear. Your child’s doctor can determine if there’s fluid in the ear by listening to the sound reflected back from the ear.

Hearing test

Your doctor may perform a hearing test to determine if your child is experiencing hearing loss.


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