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What You Need To Know About Middle Ear Infections

Know the Basics|Symptoms|Risks|Treatment|Prevention|Conclusion
What You Need To Know About Middle Ear Infections

Know the Basics

The ear is one part of the body that most people tend to overlook. The ear enables us to listen to music, sing our favorite songs, fall asleep to a lullaby, and many more. It also enables us to have a sense of balance and equilibrium, and impairment may lead to dizziness. All the things that we enjoy by our sense of hearing is possible because of our ear. However, the ear can be prone to infection.

The middle ear plays a vital role in carrying out the ear’s main function which is to detect sound. It serves the function of transmitting sound from one part of the ear (outer ear) to another (inner ear). The middle ear is also an area of the ear that’s closest to the throat, making it vulnerable to bacteria.

Learn more about the middle ear infection, what causes it, symptoms to look out for in adults, and how you can keep your ear healthy.

middle ear infection symptoms in adults

Middle Ear Infection: Definition and Causes

Your ear is made up of three parts namely the:

  • Outer ear: The outer ear is responsible for picking up sound waves and ushering them into the ear.
  • Middle ear: This is the space between the outer and inner ear.
  • Inner ear: This part of the ear contains the auditory nerves which send signals to your brain.

The middle ear is a space behind the eardrum where bones like the stirrup (stapes), the anvil (incus), and the hammer (malleus). These bones vibrate so that you can hear sounds. This part of the ear also contains the eustachian tubes and the adenoids. It’s important to learn more about these two parts of the middle ear in order to understand why ear infections happen.

The eustachian tube is the connection between the middle ear and the throat which prevents pressure and fluid from building up inside the ear. The tube does this by opening whenever you yawn, sneeze, or swallow.

The tube can get swollen or congested when you suffer from an allergy or a cold. This can lead to an accumulation of pressure and secretion in the middle ear that can cause an infection.

Another way for the middle ear to get infected is through the adenoids, which are part of the body’s system to fight off infection. Adenoids are a patch of tissues that can be found in the nasal cavity, near the opening of the eustachian tube.

Adenoids become swollen and puffy especially if they’re trying to fight off germs from entering the body. This can block the eustachian tube causing pressure and fluid to accumulate in the center of the ear, which may lead to an infection.

Middle ear infection symptoms in adults occur when the middle ear becomes infected because of a build-up of harmful bacteria. This can happen to people of all ages, but is most common among children.

Other possible causes of middle ear infections are the following:

  • When noninfectious fluid builds up in the middle ear (Otitis media with effusion)
  • When fluid build-up remains or reoccurs in the middle ear without an infection (Chronic otitis media with effusion)
  • If an infection doesn’t go away even with treatment (Chronic suppurative otitis media)


What Are the Symptoms of Ear Infection?

Most common symptoms that you have an ear infection is when you can’t hear things properly and when you’re experiencing ear pain. Other symptoms of ear infection include:

  • Fluid draining from the ear
  • Impaired sense of hearing
  • Pain in the ear
  • Feeling pressure in the ear
  • Scaly skin around or inside the ear
  • Fever*

Children, who are generally more susceptible to middle ear infection symptoms than adults, may not be able to fully express what they’re feeling. Look out for these signs in children or babies if you suspect that they have an ear infection:

  • Fever of 38 degrees Celsius or higher
  • Fatigue or lack of energy
  • Unresponsive to some sounds
  • Being fussy, restless, or crying more than usual
  • Sudden loss of appetite
  • Rubbing or pulling of the ear
  • Trouble keeping their balance
  • Discharge coming out of the ear

People, especially children, are most vulnerable to middle ear infections right after they’ve had a cold. If you’re a parent, make sure to monitor your child right after any upper respiratory infection.


Why Are Children More at Risk of Ear Infections?

Children who are aged two to four are more at risk of developing ear infections because:

  • Children’s eustachian tubes are shorter and narrower. This means that bacteria from the throat can easily travel up to the middle ear. This also makes the tubes more prone to blockage and less angulated. (Unlike in adults where the eustachian tubes are more angulated thus the secretions from the nose won’t reach the ears that easily.)
  • The adenoids are at their largest during childhood, this means that they can block the eustachian tubes much easier.

How to Treat Ear Infection in Toddlers


How Are Middle Ear Infections Treated?

Usually, doctors are able to diagnose ear infections if they see pus or fluid build-up in the areas of the middle ear. This is usually done by using an otoscope, an instrument used to view the ear canal.

One way your doctor may try to detect infection in the middle ear is by blowing a gust of air through the otoscope. If the eardrum appears to be stiff, then there is usually an accumulation of fluid behind it.

Antibiotics are only prescribed to adults and children if middle ear infection symptoms do not clear in two to three days.


How to Prevent Middle Ear Infection

Infections affecting the middle ear are usually not something to be extremely worried about. However, take extra precaution when it comes to babies and children as an ear infection can affect their hearing or development. Some ways to prevent ear infections are the following:

  • Practice good hand hygiene. Washing your hands regularly is the best way to avoid colds, which can prevent ear infections.
  • Avoid giving babies a bottle while they’re laying down.
  • Make sure to stay up to date with your child’s vaccinations.
  • Avoid secondhand smoke or quit smoking. Cigarette smoke can aggravate ear infection symptoms.


Middle ear infection symptoms in both adults and children happen when there is a build-up of fluid and bacteria in the middle ear, the area of the ear nearest to the throat. Usually, symptoms are mild and go away in a few days without treatment. However, if you find that ear pain is severe or you notice a bloody discharge then it’s best to consult with a medical practitioner right away.

Red Also:

How to Relieve Plugged Ears

How to Treat Swimmer’s Ear

Types of Hearing Loss: What You Need to Know

Hello Health Group does not provide medical advice, diagnosis or treatment.


The middle ear, https://www.hear-it.org/The-middle-ear-1, Accessed Aug. 25, 2020

Eustachian Tube Dysfunction, https://familydoctor.org/condition/eustachian-tube-dysfunction/, Accessed Aug. 25, 2020

Middle Ear Infections (Otitis Media), https://kidshealth.org/en/parents/otitis-media.html, Accessed Aug. 25, 2020

Ear infection (middle ear), https://www.mayoclinic.org/diseases-conditions/ear-infections/symptoms-causes/syc-20351616, Accessed Aug. 25, 2020

Ear infection, https://www.cdc.gov/antibiotic-use/community/for-patients/common-illnesses/ear-infection.html, Accessed Aug. 25, 2020

Middle-ear infection (otitis media), https://www.health.harvard.edu/a_to_z/middle-ear-infection-otitis-media-a-to-z, Accessed Aug. 25, 2020

*Clinical Practice Guidelines of the Philippine Society of Otolaryngology – Head and Neck Surgery on Acute Otitis Media in Children

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Written by Tracey Romero Updated Mar 29
Medically reviewed by Diana Rose G. Tolentino, M.D.