Swollen Tonsils And Ear Infections
Swollen tonsils are not usually a direct cause of ear infections. Enlarged adenoid tissue in the back of the nose can sometimes put pressure on the Eustachian tubes, preventing them from draining fluid out of the ear. However, they are more likely the source of bacteria that causes ear infections. Sometimes, doctors recommend removal for children who have very large adenoids and frequent ear infections.
What Is An Ear Infection
The commonly used term ear infection is known medically as acute otitis media or a sudden infection in the middle ear. Anyone can get an ear infection children as well as adults although ear infections are one of the most common reasons why young children visit healthcare providers.
In many cases, ear infections clear up on their own. Your healthcare provider may recommend a medication to relieve pain. If the ear infection has worsened or not improved, your healthcare provider may prescribe an antibiotic. In children younger than the age of two years, an antibiotic is usually needed for ear infections.
Its important to see your healthcare provider to make sure the ear infection has healed or if you or your child has ongoing pain or discomfort. Hearing problems and other serious effects can occur with ongoing ear infections, frequent infections and when fluid builds up behind the eardrum.
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Treatment for an Ear Infection
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What Are Other Causes Of Ear Pain
Other causes of ear pain include:
- A sore throat.
- Teeth coming in in a baby.
- An infection of the lining of the ear canal. This is also called swimmers ear.
- Pressure build up in the middle ear caused by allergies and colds.
Last reviewed by a Cleveland Clinic medical professional on 04/16/2020.
References
Key Points To Remember About Ear Infections
If you think your child has an ear infection, take them to your family doctor.
- ear infections are very common in young children
- they can cause pain, and often fever
- if you think your child has an ear infection, take them to your family doctor
- antibiotics are often not needed
- pain relief is important
- always take your child to your family doctor for an ear check 4 to 6 weeks after an ear infection, to make sure the ear fluid has gone
- most children outgrow ear infections and will have perfect, undamaged ears and normal hearing
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Fluid Buildup And Hearing Problems
Fluid behind the eardrum after an ear infection is normal. And in most children, the fluid clears up within 3 months without treatment. If your child has fluid buildup without infection, you may try watchful waiting.
Have your child’s hearing tested if the fluid lasts longer than 3 months. If hearing is normal, you may choose to keep watching your child without treatment.
If a child has fluid behind the eardrum for more than 3 months and has significant hearing problems, then treatment is needed. Sometimes short-term hearing loss occurs, which is especially a concern in children ages 2 and younger. Normal hearing is very important when young children are learning to talk.
If your child is younger than 2, your doctor may not wait 3 months to start treatment. Hearing problems at this age could affect your child’s speaking ability. This is also why children in this age group are closely watched when they have ear infections.
If there is a hearing problem, your doctor may also prescribe antibiotics to keep the fluid in the ear from getting infected. The doctor might also suggest placing tubes in the ears to drain the fluid and improve hearing.
How Can Otitis Externa Be Prevented
A dry ear is unlikely to become infected, so it is important to keep the ears free of moisture. Prevention tips include:
- Use ear plugs when swimming.
- Use a dry towel or hair dryer to dry your ears.
- Have your ears cleaned periodically by an ENT specialist if you have itchy, flaky or scaly ears, or extensive earwax.
- Do not use cotton swabs to remove ear wax. They may pack ear wax and dirt deeper into the ear canal, remove the layer of earwax that protects your ear, and irritate the thin skin of the ear canal. This creates an ideal environment for infection.
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How Do I Get An Ear Infection
Between your middle ear and your throat there is a passage called the eustachian tube. The eustachian tubes keep pressure from building up by letting air move in and out of your middle ear. When you were young, especially before you turned 3, the eustachian tubes were very small and less able to keep germs out.
The eustachian tubes get longer and usually work better in older kids, but they can still cause problems. If you have allergies or catch a cold, the eustachian tubes can get blocked up and let germs get in the middle ear. Then the number of germs can grow inside your middle ear and cause an infection.
You do not catch ear infections from other people, though you might catch a cold that then leads to an ear infection. If you have an ear infection, you might have ear pain, a fever, or trouble hearing. If you have any of these problems, tell your parent so he or she can take you to the doctor.
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Ear Infection Treatment: Antibiotics
Sometimes ear infections resolve without any specific treatment. Some ear infections are caused by viruses, and antibiotics are only effective against bacterial infections, not viral infections. It is possible that your doctor may not want to prescribe antibiotics to start. Your doctor will decide if and when antibiotics should be used.
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How Do I Know If My Child Has An Ear Infection
Older children will usually complain of an earache. While younger children might not be able to say they have an earache, they may:
- have an unexplained fever,
- tug or pull at their ears, or
- have trouble hearing quiet sounds.
Some children with an ear infection may also have fluid draining from the ear.
Can Ear Infections Be Prevented
Currently, the best way to prevent ear infections is to reduce the risk factors associated with them. Here are some things you might want to do to lower your childs risk for ear infections.
- Vaccinate your child against the flu. Make sure your child gets the influenza, or flu, vaccine every year.
- It is recommended that you vaccinate your child with the 13-valent pneumococcal conjugate vaccine . The PCV13 protects against more types of infection-causing bacteria than the previous vaccine, the PCV7. If your child already has begun PCV7 vaccination, consult your physician about how to transition to PCV13. The Centers for Disease Control and Prevention recommends that children under age 2 be vaccinated, starting at 2 months of age. Studies have shown that vaccinated children get far fewer ear infections than children who arent vaccinated. The vaccine is strongly recommended for children in daycare.
- Wash hands frequently. Washing hands prevents the spread of germs and can help keep your child from catching a cold or the flu.
- Avoid exposing your baby to cigarette smoke. Studies have shown that babies who are around smokers have more ear infections.
- Never put your baby down for a nap, or for the night, with a bottle.
- Dont allow sick children to spend time together. As much as possible, limit your childs exposure to other children when your child or your childs playmates are sick.
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Why Are Children More Likely Than Adults To Get Ear Infections
There are several reasons why children are more likely than adults to get ear infections.
Eustachian tubes are smaller and more level in children than they are in adults. This makes it difficult for fluid to drain out of the ear, even under normal conditions. If the eustachian tubes are swollen or blocked with mucus due to a cold or other respiratory illness, fluid may not be able to drain.
A childs immune system isnt as effective as an adults because its still developing. This makes it harder for children to fight infections.
As part of the immune system, the adenoids respond to bacteria passing through the nose and mouth. Sometimes bacteria get trapped in the adenoids, causing a chronic infection that can then pass on to the eustachian tubes and the middle ear.
Signs In Young Children
As babies are unable to communicate the source of their discomfort, it can be difficult to tell what’s wrong with them. Signs that a young child might have an ear infection include:
- raised temperature
- pulling, tugging or rubbing their ear
- irritability, poor feeding or restlessness at night
- coughing or a runny nose
- unresponsiveness to quiet sounds or other signs of difficulty hearing, such as inattentiveness
- loss of balance
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How Can I Tell If My Child Has An Ear Infection
Most ear infections happen to children before theyve learned how to talk. If your child isnt old enough to say My ear hurts, here are a few things to look for:
- Tugging or pulling at the ear
- Fussiness and crying
- Fever
- Fluid draining from the ear
- Clumsiness or problems with balance
- Trouble hearing or responding to quiet sounds
Why Do Children Get Ear Infections
To be fair, children arent the only ones who develop ear infections. These can strike people of all ages. But the majority of ear infections are confined to younger patients. We can blame this on anatomy.
Because children are still growing physically, some of their internal organs may also be temporarily underdeveloped. This is true of the Eustachian tube, the canal that connects the middle ear to the nostrils, providing an outlet for fluid drainage. Because the Eustachian tube is smaller in children, it is more prone to swelling when this occurs, fluid is trapped in the middle ear. This fluid presses against the eardrum, causing pain, and can harbor germs that lead to infection. The result is an earache and, in some cases, loss of hearing. When the infection does not completely go away or returns often, it is referred to as chronic.
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How Can I Prevent My Child From Getting An Ear Infection
- Wash your childs hands and your own often to reduce the chance of catching a cold.
- Breastfeed your baby.
- Avoid bottle-feeding your baby when they are lying down. Never put your baby to bed with a bottle.
- Transition your baby from a bottle to a cup by 1 year of age.
- Dont use a pacifier too often.
- Dont smoke, and keep your child away from any secondhand smoke. Exposure to smoke can increase the risk of ear infections.
- Ensure your child gets the pneumococcal vaccine .
- Ensure your child gets a flu shot every year.
What Should I Expect If I Or My Child Has An Ear Infection
Ear infections are common in children. Adults can get them too. Most ear infections are not serious. Your healthcare provider will recommend over-the-counter medications to relieve pain and fever. Pain relief may begin as soon as a few hours after taking the drug.
Your healthcare provider may wait a few days before prescribing an antibiotic. Many infections go away on their own without the need for antibiotics. If you or your child receives an antibiotic, you should start to see improvement within two to three days.
If you or your child has ongoing or frequent infections, or if fluid remains in the middle ear and puts hearing at risk, ear tubes may be surgically implanted in the eardrum to keep fluid draining from the eustachian tube as it normally should.
Never hesitate to contact your healthcare provider if you have any concerns or questions.
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Outlook For Children With Ear Infection
Often, middle ear infections will resolve on their own or shortly after starting a prescription antibiotic. If an ear infection does not resolve on its own and remains untreated, your child can experience other symptoms and illness including:
- Infection in other parts of the head
- Problems with speech and language development
- Permanent hearing loss
Symptoms Of A Middle Ear Infection
In most cases, the symptoms of a middle ear infection develop quickly and resolve in a few days. This is known as acute otitis media. The main symptoms include:
- a lack of energy
- slight hearing loss – if the middle ear becomes filled with fluid
In some cases, a hole may develop in the eardrum and pus may run out of the ear. The earache, which is caused by the build-up of fluid stretching the eardrum, then resolves.
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When To See A Healthcare Provider
The American Academy of Pediatrics promotes an approach of treating the pain and waiting for two to three days to see if it goes away, as it usually will. You should check with your healthcare provider as to when a child needs to be seen.
Ear pain that worsens or doesn’t improve, fever, and drainage with blood or pusespecially in a baby under age 6 monthsrequire medical evaluation.
Adults should call their healthcare provider when experiencing ear pain or other symptoms to learn whether they should wait or come in for an examination. Adults with otitis media should be evaluated by an ENT practitioner to rule out a nasopharyngeal cancer, which is a rare cause of otitis media in adults
Ear Infection Healthcare Provider Discussion Guide
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
A healthcare provider will be able to confirm the diagnosis by seeing signs of inflammation of the eardrum on physical examination.
If you or your child is treated for a middle ear infection, take note of when your practitioner says you should have improvement. If the ear doesn’t respond to treatment, or if new symptoms are noted, call your medical professional or pediatrician. Similarly, if any new symptoms are noted after treatment for otitis media with effusion, mention them to your healthcare provider.
What Increases Your Risk
Some things that increase the risk for middle ear infection are out of your control. These include:
- Age. Children ages 3 years and younger are most likely to get ear infections. Also, young children get more colds and other upper respiratory infections. Most children have at least one ear infection before they are 7 years old.
- Birth defects or other medical conditions. Babies with cleft palate or Down syndrome are more likely to get ear infections.
- Weakened immune system. Children with severely impaired immune systems have more ear infections than healthy children.
- Family history. Children are more likely to have repeat middle ear infections if a parent or sibling had repeat ear infections.
- Allergies. Allergies cause long-term stuffiness in the nose that can block one or both eustachian tubes, which connect the back of the nose and throat with the middle ears. This blockage can cause fluid to build up in the middle ear.
Other things that increase the risk for ear infection include:
Things that increase the risk for repeated ear infections also include:
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Will My Hearing Come Back
Approximately half of patients with SSNHL recover at least some hearing without treatment. Patients have a 75 to 80 percent chance of recovery with steroid therapy given early. The earlier that treatment is begun, the better the chances for recovery. Patients with profound hearing loss, which is a complete or near complete loss of hearing, patients who experience dizziness with their sudden hearing loss, and individuals above age 65 have a much lower chance of getting their hearing back. In those cases, you and your healthcare provider should discuss aggressive treatments to try to bring your hearing back. Hearing can take months to return after treatment is finished.
If you do not experience full hearing recovery, you may want to talk to your otolaryngologist and audiologist about hearing aids or other devices you can use to make hearing easier.