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  • Writer's pictureDr. Koralla Raja Meghanadh

Otitis Media (Middle Ear Infections) - Quick Guide

Updated: Feb 1

Otitis Media, an infection in the middle ear, is one of the most common infections in the human body. It is usually a secondary infection resulting from conditions affecting the nasopharynx, such as the common cold and sinusitis.


The middle ear requires a constant air supply to equalize pressure and facilitate proper hearing. The eustachian or auditory tube connects the middle ear to the nasopharynx, enabling this air supply. However, nose or eustachian tube issues can lead to middle ear problems.

Middle ear infection or otitis media symptoms treatment home remedies


Various events can trigger Otitis Media. Here is a list of those causes.

  • Untreated common cold

  • Forcefully blowing the nose with one nostril blocked

  • Chronic sinusitis

  • Smoking

  • Allergies

  • Growths or tumors in the nasopharynx

  • Rapid changes in air pressure (e.g., airplane travel, diving)

  • Adenoids (common cause in kids)

  • Feeding habits (main cause in babies)


If you suspect a middle ear infection, watch for the following symptoms.

  • Severe ear pain

  • Deafness or ear blockage sensation

  • Fever

  • Ear discharge


ENT doctors diagnose early-stage Otitis Media using an impedance audiometry test, which measures middle ear pressure.


For treating middle ear infections:

  1. First, treat the root cause, like a common cold or sinus issue.

  2. Use antibiotics only if the nose infection lasts over five days.

  3. Keep water out of the ear to avoid making the infection worse.

  4. See an ENT doctor for related issues like allergies.

  5. In acute cases, specific antibiotics are used to target gram-positive bacteria.

Home Remedies & Prevention

  • Treat common cold promptly and use nasal drops.

  • Inhale steam to prevent the infection's spread.

  • Avoid forcefully blowing your nose during a cold.

  • Treat chronic sinusitis

  • Avoid smoking.

  • Use anti-allergic medication as needed.

  • Gulp saliva during sudden pressure changes.

  • For babies: Feed them in a slant position and ensure they burp post-feeding.

Types of Otitis Media

  1. Acute Suppurative Otitis Media: Rapid infection development. Symptoms appear within five days.

  2. Serous Otitis Media: Gradual development over 3 to 6 weeks.

  3. Otitis Media with Effusion: Slow progression lasting over six weeks.

  4. Chronic Suppurative Otitis Media or Cholesteatoma: Prolonged infections that can damage ear structures.

Why Are Middle Ear Infections Common?

The anatomy of the eustachian tube, nasopharynx, and middle ear makes them susceptible to infections. The common cold (rhinitis) is the leading cause, followed by chronic sinusitis.


If untreated, Otitis Media can affect the inner ear, leading to more severe hearing loss, imbalance, or dizziness. Vital nerves, like the facial nerve, can also be impacted.


Otitis Media, i.e., ear infection in the middle ear, is a prevalent but treatable condition. Recognizing symptoms and seeking timely medical intervention is crucial. Prevention strategies, like proper care for the common cold, chronic sinusitis, and mindful baby feeding habits, can reduce the risk.

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What is the most common cause of middle ear infection?

The common cold is the most common cause of middle ear infections, which can result in the spread of disease to the middle ear through the nasopharynx. The risk of infection increases when we blow the nose, mainly if one nostril is blocked. The pressure created in the nasopharynx while blowing the nose can force fluids with high bacteria into the middle ear via the eustachian tube, causing otitis media. Chronic sinusitis also contributes to middle ear infections.

What happens if a middle ear infection goes untreated?

If left untreated, middle ear infections can cause several complications, such as the spread of the infection to adjacent areas such as the inner and outer ear. In addition, untreated middle ear infections can cause hearing loss and ruptured eardrums, which may require major surgery. In severe cases, the infection may even spread from the inner ear to the brain.

Dr. K. R. Meghanadh has observed cases where both chronic sinusitis, the root cause of middle ear infections, was also left untreated, resulting in the use of hearing aids and surgery. Hence, treating the underlying cause of middle ear infections is crucial to prevent such complications.

What are the symptoms of otitis media?

The symptoms of otitis media are severe ear pain, fever, ear discharge, and a feeling of deafness or blockage in the ear.

Generally, the infection begins as a common cold and progresses to the middle ear within two weeks. It can even occur in chronic sinusitis patients. During this stage, the patient may experience ear pain and blockage. The pain can intensify as the fluid builds up in the middle ear. Ultimately, the pressure will cause the eardrum to burst, discharging thick, watery pus. While the eardrum burst may relieve the pain, pus may drain from the ear as the infection persists. Fever is an uncommon symptom of this condition.

How can you prevent otitis media?

Otitis media can occur as a result of a common cold or chronic sinusitis. So, to prevent otitis media, it is important to address its root causes, namely, the common cold or chronic sinusitis. Fortunately, several home remedies are available to manage sinusitis and the common cold. By utilizing these remedies to control these infections, we can prevent otitis media or help our body combat it.

Read our article "home remedies for sinusitis" for more details.

You can find home remedies for the common cold by clicking here.

Does a middle ear infection require surgery?

A middle ear infection might need surgery, depending on the condition. Generally, acute infections(less than 6 weeks old) might be treated with medication and resolved without surgery. However, if the infection becomes chronic and persists for over six weeks, surgery may be necessary. Surgery may also be required if the infection does not respond to medication in either acute or chronic cases.

For instance, if there is a perforation in the eardrum that has been present for over three months, surgery to close the perforation may be required.

Similarly, if there is a bone infection that has persisted for more than three months, surgery may be needed.

How long does a middle ear infection last in kids?

A middle ear infection will last for around two weeks and can be resolved with proper treatment. But, if the infection does not resolve, it can develop into otitis media with effusion (chronic serous otitis media). In that case, surgical intervention is necessary. This surgery involves removing accumulated fluids and placing a grommet to prevent further fluid build-up.

To understand more about middle ear infections in children, we recommend you to read our article "What causes ear infections in a baby?"

Can otitis media spread?

Yes, otitis media can spread to other parts of the ear and nearby structures if it's untreated. In some cases, the infection can even spread to the facial nerve and chorda tympani nerve. So it is important to seek medical treatment to prevent the infection from spreading or causing complications.

Is otitis media viral or bacterial?

Most otitis media begin as a viral infection that subsides within five days. That is why doctors usually don't suggest any antibiotics during the early stage. But if the infection lasts more than seven days, we presume it is bacterial. Usually, this bacterial infection comes as a secondary infection or superadded infection. We treat the bacterial otitis media with antibiotics.

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