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  • Writer's pictureDr. Koralla Raja Meghanadh

Otitis Media in Adults: Causes and Symptoms

Updated: Jan 31

Ear infections are often associated with children, but adults can also experience them, particularly Otitis Media. This article aims to shed light on the causes and symptoms of Otitis Media in adults.

Otitis Media in Adults: Causes and Symptoms

Otitis Media or Middle ear infections

Infection in the middle ear is called Otitis Media. Although, this infection is common among all age groups. The infection's causes differ in babies, children, and adults.

90% of ear infections are caused by otitis media. It is one of the most common infections in the human body.

Causes in Adults

Here is the list of causes of otitis media

  1. Nasal Infections - common cold

  2. Blowing nose forcefully with one nostril blocked

  3. Allergy

  4. Extra growth of tissue in the nasopharyngeal area

  5. Traveling at high speed up a mountain

  6. Take a high-speed elevator over 20 floors

  7. Dive into water

  8. Flying in a plane

  9. Smoking

Nasal Infections

When you catch a cold or any nasal infection, it can easily lead to an ear infection. This happens because mucus from your nose can get into the eustachian tube that connects to your middle ear, causing an infection called Otitis Media. Most ear infections start from a cold and affect the middle ear.

Additionally, the nasal cavity has a mucus lining that runs into the eustachian tube. A nasal infection can cause inflammation in this lining, resulting in blockage leading to middle ear infection, especially when the tube is thin by birth.

Blowing nose

If you have a cold and blow your nose forcefully, especially with one nostril blocked, you risk pushing fluids from the back of your nose into the tube that connects to your middle ear. Thick fluids can block this tube, while thin fluids can end up in the middle ear itself. Both situations can lead to a middle ear infection.

Chronic Sinusitis

Chronic sinusitis can contribute to middle ear infections, also known as Otitis Media. This happens because the mucus produced in chronic sinusitis can travel down the auditory or eustachian tube, which links the back of the nose to the middle ear. This mucus can either block the tube, disrupt ear pressure, or directly enter the middle ear, creating a ripe environment for infection. Symptoms often include ear pain and clogged ears. Treatment of the underlying sinusitis usually helps resolve the ear infection, but severe cases may require medical intervention.


Allergies are common, affecting up to 30% of people, and many don't even know they have them. Allergies can inflame the lining in your nose, throat, and even your ears. This can lead to symptoms like sneezing, a sore throat, and coughing. If the allergic reaction is severe enough to fully block the ear's eustachian tube, it can cause an ear infection. Partial blockage also makes you more susceptible to ear infections. If you're not treating your allergies and your tube is partially blocked, you're at higher risk for frequent middle ear infections, also known as otitis media.

Tumor or extra growth of tissue in the nasopharyngeal area

If something blocks the nasopharynx—the area at the back of your nose—it might also block the eustachian tube that connects to the middle ear. This prevents air from flowing in, creating a pressure imbalance in the middle ear. Fluid can then accumulate there, providing a breeding ground for bacteria and leading to a middle ear infection called Otitis Media.

Extra growth of adenoids can also cause otitis media and is the leading cause in children.

Sudden altitude changes

Quick changes in air pressure can happen due to sudden altitude changes when you:

  • Speed up a mountain

  • Take a high-speed elevator over 20 floors

  • Dive into water

  • Fly in a plane

If the tube connecting your middle ear to the back of your nose is partly blocked, maybe due to allergies or some fluids, or is thinner than it should be, it can't adjust the ear pressure fast enough in the above scenarios. This can lead to fluid getting trapped in your middle ear, which can cause a bacterial infection known as Otitis Media.


Smoking or being around smoke can irritate the lining of your nose, throat, and even the tube that connects your ear to your nose. This irritation can block the tube, messing up the pressure in your middle ear. When that happens, fluid can get trapped in your ear, creating a breeding ground for bacteria and leading to an infection called Otitis Media.

Symptoms in Adult's Middle Ear Infections

Otitis Media, or Middle Ear Infection, is a common issue that often starts with a cold, as mentioned before. It's the culprit behind 90% of ear infections.

  • Ear pain

  • A feeling of blocked or clogged ears or deafness.

  • Ear discharge

  • Fever - a rare symptom

Understanding the causes and recognizing the symptoms can be the first step toward effective treatment for Otitis Media in adults.

How Symptoms Develop and Progress in Otitis Media

Middle ear infections often originate from a common cold and generally transition to the middle ear towards the end of the cold or in its second week. Initially, patients experience either ear pain or a sensation of blockage, or both.

As fluid or pus accumulates, it disrupts eardrum vibration and alters air pressure in the middle ear. Pain intensifies as a result. Eventually, the increasing pressure can cause the eardrum to rupture, leading to pus discharge and a reduction in pain.

Once the eardrum is perforated, bacteria from the outer ear can enter the middle ear, worsening the infection and potentially increasing hearing loss. Hearing loss usually ranges from 10% to 30%.

As the infection intensifies, the body sends more blood to the ear to aid white blood cells in combating the infection. This could damage the delicate ear bones, leading to up to 60% hearing loss. Total hearing loss is possible if the infection spreads to the inner ear. Fever is a rare but possible symptom.

Important Note:

Ear infection can spread from one part of the ear to another, making a person experience other symptoms too. So, it is always better to be safer and get a doctor's diagnosis.

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