Topic Card 11: Middle Ear Related Problems


Related Terms:

Otitis Media; Middle Ear Effusion;  Tympanic  Membrane;   Otolaryngologist;   Myringotomy;   Eustachian Tube; External Auditory Canal


What is otitis media?

What causes otitis media?

What kind of hearing problem can be caused by otitis media?

How should middle ear problems be managed?

Can middle ear problems affect my child’s development?

What can I do if my child has missed out on listening opportunities because of an ongoing or recurrent conductive hearing loss?

  •  What is otitis media?

Otitis media is an inflammation of the middle ear that usually occurs as the result of a middle ear infection. Common symptoms can include fever, pain, hearing problems, ruptured eardrum, drainage, decreased appetite, general fussiness, and pulling or swatting at the ear. Otitis media is commonly associated with fluid build-up or middle ear effusion behind the tympanic membrane (eardrum).

  • What causes otitis media?

In a healthy ear, the air pressure in the middle ear is equal to the air pressure outside the ear. The eustachian tube (connects the back of the throat to the middle ear) opens and closes so that air from the throat can enter the middle ear to keep the pressure equal. Sometimes colds, allergies, and other upper respiratory infections can cause the eustachian tube to become blocked and can result in a fluid build-up.

  • What kind of hearing problem can be caused by otitis media?

A conductive hearing loss, a loss that is caused by a blockage of the outer or middle portions of the ear, is most often associated with otitis media. This is usually a temporary loss that may fluctuate over time depending on the degree of inflammation, infection, and/or fluid build-up. The greater the amount of fluid and the thicker it is, the greater the hearing loss will likely be. If your child already has a sensorineural (inner ear or nerve) hearing loss, an additional conductive hearing loss will cause greater hearing difficulties for your child. When the fluid is gone, the conductive portion of the hearing loss should disappear. If there is an existing permanent (sensorineural) loss, that portion of the hearing loss will return to its previous level.

  • How should middle ear problems be managed?

If  your  child  has  ongoing  middle  ear  problems,  you  should  seek  medical  treatment  from  an otolaryngologist (also known as an ENT), a physician who specializes in disorders of the ears, nose, and throat. Provide your ENT with records from the pediatrician as well as a complete history of your child’s middle ear problems including how often he or she gets ear infections, what antibiotics have been used, and if the ears remain clear after treatment. The doctor may use other types of antibiotics to clear the fluid or infection. The ENT may also recommend a myringotomy with ventilation tubes. This is a minor surgical procedure in which a tiny tube is placed into the tympanic membrane (ear drum). The tube allows any fluid to drain out and helps keep the air pressure in the middle ear equal to the air pressure in the external auditory canal (ear canal). Both of these things are important for a healthy middle ear and for hearing.

  • Can middle ear problems affect my child’s development?

Even a mild hearing loss can have an effect on language development. Children with normal hearing spend the first 12 to 18 months of life learning to listen and understand before they begin to talk. With repeated ear infections and even a mild hearing loss, this important listening and learning time may be l ost or significantly reduced.

  • What can I do if my child has missed out on listening opportunities because of an ongoing or recurrent conductive hearing loss?

A little extra attention to the listening and language opportunities that occur during play and day to day routines will help your child’s speech and language development. Here are some ideas:

  • Try to be no more than five to six feet from your child when you talk. Even with a mild hearing loss, it’s hard to hear at a distance.
  • Gain your child’s attention before speaking and face your child when speaking.
  • Turn off the radio or television when talking to your child. It’s much more difficult to listen in a noisy room.
  • Pay attention to your child’s communication “signals” and respond to them. Early communication signals may include pointing, gazing (looking), or vocalizing. Give your child a word or short phrase to fit the situation. For example, if your child is pointing to the cereal, you might say, “You like cereal”; or, “You’re hungry;” or, “Do you want more cereal?”
  • Help your child learn new words and phrases. If your child points to your family pet and says, “Doggy”, your response may be, “Yes, that’s your doggy;” or, “You see Boots. He’s your doggy.” If your child is already using short sentences, model an example of a longer sentence or a sentence that includes a new word. An example might be “Your dog is under the rocking chair”.
  •  Respond to your child’s attempts to communicate with enthusiasm and praise. Your response will encourage more communication.