Taking a Close Look at Ear Infections

Most parents are familiar with the symptoms of an ear infection:  tugging at the ears, crying more than usual, fluid draining from the ears, difficulty sleeping or keeping balance, hearing problems. That’s because ear infections are the most common illnesses in babies and young children. In fact, three out of four children experience an ear infection by the time they reach their third birthday. I talked with Dr. Anthony D'Angelo, otolaryngologist (ear, nose, throat) specialist on staff at Des Peres Hospital about the condition.

"Ear infections, also called otitis media, happen when viruses or bacteria enter the ear and cause an infection. Ear infections are not contagious, but they may be the result of another illness, such as a cold," said D'Angelo.  "Ear infections occur more often in boys than girls, and in children who have a family history of the condition. Ear infections tend to increase in frequency during the winter months when upper respiratory tract infections or colds are more frequent."

D'Angelo said the risk of developing ear infections can be minimized by making certain lifestyle choices:

• Breastfeeding the infant for at least six months
• Avoiding exposure to second-hand smoke
• Reducing exposure to a large number of children
• Washing hands to decrease the transmission of germs
• Keeping immunizations up to date

If symptoms of an ear infection appear, call a doctor immediately. Viral ear infections, such as those caused by a cold, often go away on their own in several days; however, antibiotics may be prescribed for an infection caused by bacteria. The medication must be finished to ensure successful treatment or else the infection can come back.

"Children who experience frequent infections may need surgery to relieve pressure in their ears," said D'Angelo.

More than 500,000 ear tube surgeries are performed on children each year. The procedure, called a myringotomy, is the most common childhood surgery performed with anesthesia.  

"It takes about 15 minutes to make a tiny opening in the ear drum, suction out fluid behind the ear drum and then insert a small tube," explained D'Angelo. "After surgery, the child often can hear better because fluid cannot build up in the ear when it is vented with fresh air. Removal of the adenoids, which can block the openings of the Eustachian tubes, also may be recommended to reduce the risk of chronic ear infection and the need for repeat surgery."

If there are no complications with the surgery, children usually go home from the hospital within an hour. Ear drops may be necessary for a few days following surgery. To prevent bacteria from entering the ear through the tubes, doctors may recommend using ear plugs during bathing or swimming. The tubes will generally fall out on their own after a few months. In certain cases, the surgery may need to be repeated.

D'Angelo said there is no single best way to treat ear infections. Doctors will take into account the child’s age, frequency and length of infection, risk factors, and effect on hearing and behavior when making their diagnosis and prescribing a course of action.

He cautioned, "It is important to seek treatment because, if left untreated, ear infections can lead to permanent hearing loss or impaired speech development."