Otitis Media

Otitis media is an infection or inflammation of the middle ear, the air-filled space behind the eardrum that contains the small bones responsible for hearing. It may affect one or both ears and can occur as:

• Acute otitis media, which develops suddenly and is usually associated with pain and fever

• Chronic otitis media, where infection or inflammation persists or recurs over time

• Otitis media with effusion (serous otitis media), where fluid remains behind the eardrum without active infection, often causing hearing difficulties and a sensation of fullness

Otitis media is more common in children due to the structure of the Eustachian tube, but adults can also develop it, especially following upper respiratory or sinus infections.

Otitis media typically develops when bacteria or viruses travel from the nose or throat into the middle ear through the Eustachian tube. When this tube becomes blocked or swollen, fluid may accumulate behind the eardrum, creating an environment for infection.

Common contributing factors include:

• Colds, flu, or respiratory infections

• Allergies causing nasal congestion

• Sinus infections

• Exposure to cigarette smoke or environmental pollutants

• Enlarged adenoids blocking the Eustachian tube

• Feeding infants while lying flat

• Recurrent ear infections or family history of ear disease

ENT specialists assess these factors to determine the underlying cause and guide appropriate treatment.

Symptoms may vary depending on age and severity and can include:

• Ear pain or pressure

• Reduced or muffled hearing

• Fluid discharge from the ear

• Fever or irritability in children

• Difficulty sleeping or ear pulling in young children

• Sensation of fullness in the ear

• Dizziness or balance disturbances

In cases of otitis media with effusion, pain may be absent, but hearing difficulties are common.

Diagnosis begins with a clinical ENT evaluation and review of symptoms and medical history. Diagnostic methods may include:

• Otoscopy: Visual examination of the eardrum for redness, bulging, or fluid

• Tympanometry: Measurement of eardrum movement to detect fluid or pressure changes

• Hearing tests: Audiological evaluation to assess hearing impairment

• Imaging (when required): In chronic or complicated cases, imaging may be used to assess middle ear structures

These evaluations help guide safe and appropriate management.

Treatment depends on the severity, frequency, and underlying cause of the infection.

Medical Management

Mild and uncomplicated cases may be managed with:

• Pain relief medication

• Warm compresses for discomfort

• Nasal sprays or decongestants to improve Eustachian tube function

• Antibiotics when a bacterial infection is confirmed

• Allergy management when indicated

Patients are monitored to ensure symptom resolution and to identify any persistent fluid buildup.

Treatment of Otitis Media with Effusion

When fluid remains in the middle ear, treatment focuses on improving ventilation and drainage. Options may include:

• Nasal steroid sprays to reduce inflammation

• Pressure equalization techniques

• Treatment of nasal or sinus conditions contributing to blockage

If fluid persists and affects hearing, further intervention may be considered.

Surgical Management

Surgical treatment may be recommended for recurrent infections or long-standing fluid buildup affecting hearing.

• Myringotomy with tube insertion: A small opening is made in the eardrum to drain fluid, and a ventilation tube is placed to maintain airflow

• Adenoidectomy: Removal of enlarged adenoids when they contribute to repeated ear infections or Eustachian tube blockage

These procedures are performed under appropriate anesthesia in a controlled clinical environment.

Untreated or recurrent otitis media may lead to:

• Persistent hearing loss

• Eardrum perforation

• Chronic ear discharge

• Spread of infection to nearby structures (rare)

• Speech or developmental delays in children

Early evaluation helps reduce the risk of these complications.

Most patients recover within a few days to weeks, depending on the severity of infection and treatment approach. Aftercare may include:

• Completing prescribed medications

• Avoiding water entry into the affected ear

• Follow-up visits to monitor healing and hearing

• Managing allergies or sinus issues to prevent recurrence

Treatment cost varies depending on:

• Diagnostic tests required

• Type of treatment (medical or surgical)

• Duration of care and follow-up needs

A detailed explanation of the treatment plan and associated costs is provided during consultation.