Otitis media

Acute otitis media

An inflammation of the middle ear (otitis media or acute otitis media) occurs in the eustachian tube, the connection between the middle ear and the throat, and is very painful. In most cases it heals on its own. Small children are most commonly affected by middle ear infections, but adults can also get them. In any case, it is advisable to contact us. We can assess and evaluate the acute situation and take therapeutic measures to prevent possible complications.

Overview: What is otitis media?

A middle ear infection is usually caused by a cold with its usual accompanying symptoms such as a cold, sore throat and cough. The middle ear infection itself is not contagious, it is triggered by

  • bacterial or
  • viral infections.

These infections are of course contagious. Pathogens travel from the nasopharynx via the Eustachian tube or Eustachian tube – the connecting piece between the nose, throat and middle ear – into the middle ear. Inflammatory processes cause the eustachian tube to swell, fluids can no longer drain away as usual and pressure builds up. In children, the Eustachian tube is much shorter and swells up more easily – one reason why children under the age of three often suffer from middle ear infections. The pressure in the middle ear can cause severe, stabbing ear pain. Children usually also have a (high) fever. Adults can also get otitis media, usually as a result of a severe cold.

If the fluid pressure in the middle ear becomes too high, the eardrum may rupture. For the person affected, this is associated with relief, as the pain then subsides. The tear heals again, but frequent middle ear infections can cause scars to form on the tissue, which in turn cause hearing impairment. Today, middle ear infections are no longer treated immediately with antibiotics. We try to alleviate the symptoms with suitable painkillers and anti-inflammatory agents and wait and see. After a few days, the swelling of the eustachian tube has usually subsided, the fluids have found their way and the accompanying symptoms subside.

If you have acute ear pain, you should still come to us in any case. We will monitor the course of the otitis to ensure that no complications or damage occurs.

Otitis media: causes and risk factors

Otitis media is always the result of a respiratory infection. Triggers can be:

  • Cold viruses
  • Influenza viruses
  • Bacteria (pneumococci, A streptococci, staphylococci)
  • Haemophilus influenzae

The usual route is via the nasopharynx towards the middle ear, but germs rarely enter via the external auditory canal or an injured eardrum. However, germs that are spread in the blood or measles and scarlet fever pathogens can also cause otitis media. Frequent throat infections are also a source of germs for otitis. Risk factors for middle ear infections include large adenoids or a cleft palate, which can impair drainage from the Eustachian tube and be a contributory cause of inflammation in the middle ear area. Living in a smoking household also appears to be a risk factor for children.

Symptoms: Otitis media

A middle ear infection manifests itself with severe ear pain and possibly also muffled ringing in the ears. This is accompanied by fever and pressure on the ears. Fatigue and feeling ill are related to the causative infection. Sometimes those affected also complain of hearing loss or headaches. Babies and toddlers show crying behavior, have a fever, drink poorly and sometimes touch their ears. Young children can also complain of abdominal pain in connection with otitis. The pain can last for a few days, but as soon as the eustachian tube swells and the fluid can drain away, the pressure also decreases and those affected are increasingly symptom-free.

Otitis media – diagnosis with us

To avoid complications and secondary diseases, it always makes sense to come to us with severe ear pain. We will look at the eardrum with an otoscopy (ear examination with a microscope). The healthy eardrum has a gray color and appears reflective and slightly transparent. Are here

  • Bubbles,
  • Redness,
  • Thickenings,
  • Bulges or
  • Leaking liquid

then the suspicion of a middle ear infection is obvious. We use tympanometry to check the functions of the middle ear, measure the pressure and test the mobility of the eardrum. With the help of a hearing test, we can detect hearing loss or hearing disorders. Especially in the case of frequent middle ear infections, this may be an important indication for further therapy.

In some cases, imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI ) may also be used.

Otitis media – complications

A complication of otitis is mastoiditis, a spread of the infection to the mastoid process of the temporal bone. This is the part of the skull bone that lies directly behind the ear. The bone cells become inflamed and, in the worst case, the infection migrates to the inside of the skull with life-threatening consequences. So if you discover redness or swelling behind the pinna in the case of a middle ear infection, which is also sensitive to pressure, you should contact us immediately. Fluid draining from the ear, fever and increased pain are also part of this and should be seen as warning signs. Mastoiditis can also manifest itself with fewer symptoms and fester for a long time; experts then speak of chronic mastoiditis. However, the serious complications are the same. In rare cases, dizziness, deafness or facial paralysis may also occur.

Otitis media: prevention, early detection, prognosis

By the age of three, 80 percent of children have had at least one middle ear infection. Infections can hardly be prevented, especially in young children, but you can minimize the risk a little.

  • Nuggi: Studies show that children who suck on a nuggi a lot are more likely to get middle ear infections.
  • Pneumococcal vaccination: It appears to provide partial protection in young children.
  • Flu vaccination: This vaccination slightly reduces the risk of middle ear infection.
  • Breastfeeding: This has a protective effect – breastfed children are less likely to develop otitis in the first two years.

And, of course, a healthy lifestyle, playing outdoors and a certain amount of toughening up helps to make you more resistant to colds. You should refrain from smoking in the presence of children, as it lowers the immune system and damages children’s airways.

Normally, a middle ear infection heals within two weeks, and the majority of sufferers have no more pain after just one day. Antibiotics are no longer used for treatment today, unless complications become apparent. After the age of seven, the risk of middle ear infection decreases, but in principle you can still get it as an adult.

Recurrent middle ear infections are usually caused by particular anatomical conditions (adenoids, tonsils) that prevent or impede good ventilation of the Eustachian tube. In this case, surgery may be advisable.

Otitis media: Treatment depending on severity

The treatment of otitis media is all about alleviating discomfort. It is important to drink plenty of fluids to initiate healing processes and to liquefy and drain secretions.

For patients

As a patient, you cannot register directly for a consultation. Please get a referral from your primary care physician, specialist.

For referrer

University Hospital Zurich
ORL clinic
Frauenklinikstrasse 24
8091 Zurich

Tel. +41 44 255 58 33
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