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Otitis Media

Otitis media is an inflammation in the middle ear (the area behind the eardrum) that is usually associated with the buildup of fluid. The fluid may or may not be infected.

Symptoms, severity, frequency, and length of the condition vary. At one extreme is a single short period of thin, clear, noninfected fluid without any pain or fever but with a slight decrease in hearing ability. At the other extreme are repeated bouts with infection, thick “glue-like” fluid and possible complications such as permanent hearing loss.

Fluctuating conductive hearing loss nearly always occurs with all types of otitis media. In fact it is the most common cause of hearing loss in young children.

Otitis media is the most frequently diagnosed disease in infants and young children (1). Seventy-five percent of children experience at least one episode of otitis media by their third birthday. Almost one-half of these children will have three or more ear infections during their first 3 years of life (2). Health costs for otitis media in the United States have been reported to be $3 billion to $5 billion per year (3).

Why is otitis media so common in children?

The Eustachian tube, a passage between the middle ear and the back of the throat, is smaller and nearly horizontal in children than compared to adults. Therefore, it can be more easily blocked by conditions such as large adenoids and infections. Until the Eustachian tube changes in size and angle as the child grows, children are more susceptible to otitis media.

Three tiny bones (ossicles) in the middle ear carry sound vibrations from the eardrum to the inner ear. When fluid is present, the vibrations are not transmitted efficiently from the eardrum through the ossicles and sound energy is lost. The result may be mild or even moderate hearing loss. Therefore, speech sounds are muffled or inaudible.

When fluid is present behind the eardrum, the eardrum becomes thicker and often times retracted into the middle ear space. Because of this it doesn’t vibrate as efficiently to conduct sound to the three tiny bones in the middle ear which carry the sound vibrations to the inner ear. As a result, sound energy is lost. The result may be mild or even moderate hearing loss. Therefore, speech sounds are muffled or inaudible.

Generally, this type of hearing loss is conductive and most often temporary and fluctuating. However when otitis media occurs over and over again, damage to the eardrum, the bones of the ear, or even the hearing nerve can occur and cause a permanent sensorineural hearing loss.

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