Otitis media is an infection of the middle ear that occurs when fluid builds up behind the eardrum. There are different types of otitis media that display different symptoms. Cases of otitis media can usually be treated with at-home or over-the-counter remedies.
Otitis media (OM) is a middle ear infection that occurs when fluid builds up behind the eardrum. While this condition is sometimes referred to as otitis media disease, it is actually a common form of ear infection that affects people of all ages, and is one of the most common infections in children worldwide.¹ Despite the accompanying pain in some types of this middle ear infection, otitis media is treatable and can improve with the right care.
There are three types of otitis media, including acute otitis media (AOM), otitis media with effusion (OME) and chronic otitis media (COM).
Acute otitis media is a rapid onset of inflammatory symptoms in the middle ear. Within acute otitis media, there are specific forms that present differently.
Nonsuppurative otitis media is a broad term used to describe any middle ear condition where there's no pus formation. Otitis media with effusion is a type of nonsuppurative otitis media where fluid collects in the middle ear without an active infection or significant inflammation.
It is sometimes referred to as “glue ear” due to the fluid trapped in the ear.¹ Serous otitis media and otitis media mucoid describe the different types of fluid: watery and mucus, respectively.
Chronic otitis media (COM) develops after repeated acute otitis media infections, which leave behind a perforated tympanic membrane (eardrum), scarring or damage to the middle ear.
It is sometimes referred to as otitis media with perforation, and the rupture allows discharge to drain from the middle ear into the external ear canal. Chronic otitis media doesn't always involve an active infection; instead, it becomes a structural issue.
Otitis media symptoms vary depending on the type of OM.
What causes otitis media can be various conditions. Bacterial infections like pneumococcus and viral infections, such as colds or the flu, are common triggers. Allergies and sinus infections can also block the Eustachian tubes, leading to fluid buildup. Another cause of OM is Cytomegalovirus (CMV), linked to a herpesvirus, which makes people with weak immune systems or newborns especially vulnerable. Children exposed to secondhand smoke are more vulnerable to OM due to the inflammation of their respiratory system and compromised immune system. Additionally, aero-otitis media, caused by air pressure changes during activities like flying or scuba diving, can also lead to an infection due to the inability of the Eustachian tubes to adjust quickly enough.
Certain conditions and behaviors increase the chances of developing a middle ear infection. Otitis media risk factors include smoking or secondhand smoke, age (younger children and older adults are more at risk), genetic predisposition, frequent colds or upper respiratory infections, and allergies. Additionally, children in daycare are more exposed to colds, and pacifier use increases the risk of OM¹ by affecting the Eustachian tube and altering middle ear pressure.
Otitis media, if poorly managed, can have long-term implications. Complications of otitis media include temporary or permanent hearing loss, balance issues, and speech or developmental delays in children.
Untreated otitis media can lead to a bone infection called mastoiditis, which can be life-threatening if not treated promptly, and malignant otitis media, a severe infection that starts in the external ear canal and can spread to the surrounding tissues, including the bones of the skull.
Doctors diagnose otitis media by first reviewing symptoms. Using an otoscope, they check for signs of infection, such as redness, swelling or fluid behind the eardrum. If needed, additional tests like tympanometry or hearing assessments may be done to confirm the diagnosis or check for complications.
When it comes to otitis media treatment, understanding the available otitis media medication and intervention options is key to managing symptoms and preventing complications.
To help prevent otitis media, focus on staying healthy through regular vaccinations, including the flu and pneumococcal vaccines, and practicing good hand hygiene. Additionally, avoid exposure to smoking and secondhand smoke to reduce risk factors.²
Otitis media and otitis externa differ in location and cause. Otitis media is usually triggered by infections like bacteria or viruses, while otitis externa (or swimmer’s ear) typically arises from trapped moisture.
1 “Otits Media.” National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC7097351.
2 “Preventing and Treating Ear Infections.” Centers for Disease Control and Prevention. www.cdc.gov/ear-infection/media/pdfs/Ear-Infection-508.pdf.
