All You Need To Know About Ear Infections (Otitis)

Ear infections or otitis represent several million consultations each year. In our country, two out of three children suffer from ear infections before their third birthday. In other words, ear infections is an extremely common condition in small children, especially in winter.
There are solutions to avoid ear infections, but we need to know how to act quickly when they occur. Ear pain and fever are the most classic symptoms that can alert us. Before knowing how to treat ear infections (to be discussed in a future article) it is necessary to first understand what are they, what are their most common causes, their symptoms, and their different types. That’s what you’ll see in this topic.

1. What are Otitis?

Otitis are infections or inflammations of the ear. They are very common, especially in children from 6 months to 3 years and can touch one or both ears. Generally, not serious, they do not leave sequels after the cure. Most ear infections are caused by viruses and manifest during a cold. Ear infections may occur in isolation, or may occur with another disease, such as nasopharyngitis or angina.

2. What Are The Types of Ear Infections (Otitis)?

The ear is divided into three parts: the outer ear (including the ear canal), the inner ear (where the liquid receives the sound vibrations), and the middle ear between the other two (including the eardrum, the tympanic cavity and the three ossicles; the hammer, the anvil and the stirrup).
There are several types of ear infections depending on which part of the ear is affected:

2.1) Otitis Externa

Otitis externa, more commonly known as ‘swimmer’s ear’, is an inflammation or infection of the skin of the external auditory canal. Inflammation and abscess can completely close the duct. It takes its name from the fact that it is often due to excessive moisture in the outer ear, which sometimes occurs after swimming. This moisture promotes the growth of bacteria.

Causes of otitis externa:otitis externa
Otitis externa are usually caused by bacteria or microscopic fungi. Some factors may facilitate contamination by these infectious agents such as:

  • Excessive exposure to water, such as in swimmers or divers.
  • Long exposure to chlorinated water or poor use of cotton swabs, which dry out the canal.
  • Swimming in dirty water.

Symptoms of otitis externa:
The symptoms of this type of ear infection can be the following:

  • At the beginning, itching at the level of the external auditory canal.
  • Then, a swelling of the external auditory canal and of the earlobe is manifested. The person has the impression of having a cork in the ear accompanied by pain. Pain can be increased at night.
  • Slight liquid flow from the ear but in some cases, it is also possible to have a lot of flows.
  • Hearing may even be reduced.
  • Difficulty in chewing (when eating).
  • In some severe cases, big swelling in the ear.

2.2) Acute Otitis Media

otitis mediaAcute otitis media is an infection of the middle ear involving the eardrum or the tympanic cavity; a small bone cavity located between the eardrum and the inner ear and containing the ossicles.
In fact, this type of ear infection is frequently the result of an infection in the respiratory system; In this case the Eustachian tube (which connects the ear to the nose) becomes blocked. Then, pus (infected fluid) accumulates and infects the middle ear.
Acute otitis media is one of the most common infectious diseases of childhood, it is estimated that more than 75% of 3-year-olds have had at least one episode of this kind of ear infections.

Causes of acute otitis media:

  • The causes of acute otitis media are usually caused by bacteria such as pneumococci or streptococci or other infections of the respiratory tract. In some cases, acute otitis media may also be of viral origin, as a result of a cold. This kind of ear infections can also be caused by an allergy reaction or air pollutants.

Symptoms of acute otitis media:
Symptoms of acute otitis media are usually:

  • The accumulation of secretions in the middle ear causing pain, edema and redness of the eardrum. It also prevents the eardrum from vibrating properly, which often leads to (temporary) hearing problems.
  • Violent pain in the ear.
  • Fever.
  • Effusion of pus through the external auditory canal in case of perforation of the eardrum.
  • Sometimes a transparent abscess visible behind the tympanum.
  • Sometimes vomiting and diarrhea.
  • Difficulty in sleeping.
  • Headache.
  • Loss of appetite (because chewing becomes painful).

When the secretions collected behind the eardrum can no longer be eliminated, the otitis media becomes worse. The disease can become chronic as a result of the repetition of acute infections that eventually lead to a decrease in hearing. Otitis media can also cause rupture of the eardrum.

2.3) Serous Otitis

serous otitisSerous otitis (called also otitis with effusion) is an inflammation of the middle ear that lasts for more than 3 weeks. It is accompanied with an effusion of liquid enclosed behind the eardrum and badly evacuated by the Eustachian tube. This serous fluid (citrus yellow and fluid) or mucous (whitish and sticky) accumulates in the tympanic cavity. Indeed, and contrary to the classical otitis, it is not the eardrum which is the first touched but the eardrum cavity. The cavity being full of glue, the transmission of sounds is bad and the patient hears less well.
These ear infections are common in children between 1 and 5 years of age, especially in winter.

Causes of serous otitis:

  • A viral or bacterial infection of the nasal cavity, often with acute otitis media, whose evolution has not been adequately monitored.
  • Accumulation of serosities in the ear which exerts pressure on the eardrum following a malfunction of the Eustachian tube.

Symptoms of serous otitis:

  • Hearing loss on the affected side is the most straightforward sign but difficult to spot in babies. This diminution of hearing is due to the loss of mobility of the ossicles, because of the liquid which surrounds them.
  • Pains and sensations of ear clogged. These pains are a little more marked at night in young children.

2.4) Barotraumatic Otitis

Barotraumatic earache is a type of otitis media that affects the middle ear and occurs when the pressure difference between the two sides of the eardrum is too great. The eardrum then deforms and can even tear, which sometimes leads to lesions on the ossicles and a risk of infection.

Causes of barotraumatic otitis:

Two contexts account for the vast majority of barotraumatic otitis:

  • Scuba diving, with a maximum risk on descent and especially at the first landing between 3 and 4 meters deep.
  • Sudden changes in altitude: take-off or landing of an aircraft, sudden depressurization, skydiving of the parachutist (in fact, all rapid changes in altitude).

Symptoms of barotraumatic otitis:

  • A sharp pain in the ear.
  • A marked decrease in hearing, especially in the event of rupture of the eardrum.
  • A clogged ear feeling.
  • Tingling or tinnitus.
  • Sometimes dizziness.
  • If the eardrum is torn, bleeding or flow through the ear canal is possible.

3. Recurrent and Persistent Ear Infections?

Some children have otitis after every cold or sore throat and the inflamations can be very painful. Adults are also not safe. The operation is not always possible and these inflammations are very painful. Most otitis usually go away on their own. If they return incessantly, they are called recurrent infections. Recurrent otitis can cause chronic infections can cause big hearing problems. The followin points may favor recurrences of ear infections especially in children:

  • Hypertrophy of adenoids.
  • Untreated serous otitis.
  • Contamination, for example in schools.
  • Passive smoking.
  • Pollution.
  • Allergies (respiratory allergy in response to pollen or domestic dust, for example, but also allergy to food).
  • Iron deficiency, etc.

It should be noted that adults who have frequently had ear infections during childhood are more likely to become deaf, according to a British study published in Ear and Hearing journal. Hence the importance of preventing these infections by protecting the ears of toddlers.

4. Possible Complications and Risks of Ear Infections

ear infections - otitisNormally an acute otitis rarely causes very serious complications. It usually heals within five to ten days. But in some cases, these ear infections can lead to serious complications, from meningitis to complete deafness. For these reasons ear infections should be carefully monitored to prevent the risk of superinfections which could have serious conséquences on the auditory system.
The risks that can be caused by neglected and untreated otitis are as follows:

  • Thickening and degradation of the eardrum. If these ear infections become chronic, they can lead to severe eardrum defects and lead to hearing loss.
  • If the Eustachian tube is blocked for a long time, the air can not reach the middle ear which gradually retracts.
  • The eardrum will gradually become attached to the various structures occupying the middle ear and form in some cases real pockets called “retraction pockets”. In serious forms, these are real cysts, full of epidermal waste that will evolve on their own account, grow, infect and destroy the elements occupying the middle ear: this is called cholesteatoma. This, if not detected and operated, can destroy the osseous structures and what they contain (bones, labyrinth, etc.).
  • Sometimes the eardrum may crack under the pressure caused by the infection. In this case, pus or blood from the infected ear is discharged. This may seem alarming to you, but this rupture relieves the pain and repairs itself in a few days. But if it gets punctured frequently, then surgery may be necessary.
  • Complications can go as far as serious infections such as meningitis or pneumonia.
  • Infants under one year of age are also affected by potential meningitis.
  • The complication of otitis media can give rise to serious infections like mastoiditis or labyrinthitis.
  • Complications can lead also to facial paralysis which can take place brutally, and completely. It is directly related to the degeneration of otitis media.

5. Diagnosis and Treatment of Ear Infections

ear infections - otitis

Depending on whether it is viral or bacterial, the treatment of otitis will not be the same. Antibiotic treatment is effective only on bacterial infections.
A few signs can help you determine the origin of ear infections; In the case of bacterial otitis, the fever is severe, the acute pains and the appearance of the eardrum is purulent, or even already perforated. In addition, when the otitis is on both ears, it is then of bacterial origin.
In the case of viral infections, the general condition of the sick person or child is better.
The good news is that 80% of ear infections can be cured on their own. Once the origin of the ear infection is determined, the treatment of otitis can be done in two stages; Relieve pain, then treat its origin.

  1. Relieve the pain of  the ear infection:
    The pain associated with an ear infection can be relieved, like all pain, with over-the-counter analgesics or natural homemade remedies.
  2. Treat the origin of the ear infection:
    As said before, it is necessary to know the origin of the ear infection to be able to remedy it.
    There are natural remedies for ear infections like essential oils. These treatments will be discussed in a future article. On the other hand, if the pain persists even after taking analgesics and especially if you have a fever that lasts for more than 3 days, then it is obligatory to consult a doctor who will provide you the good treatment.

6. Prevention of Ear Infections – Daily Tips 

Ear infections occur mostly in summer and winter. In summer, they are usually due to bathing and in winter to viruses.
Precaution is probably the most important. Some everyday actions are very important to avoid ear infections:

  • First of all, it is recommended to drain the nasal cavities well. Mouthing and washing of the nose is essential, in order to avoid as far as possible any passage of new microbes from the nose to the ear. With water pipettes for babies or a good gagging for the older ones, do not hesitate to maintain the hygiene of the nose to limit the otitis.
  • For toddlers, blow your child several times a day; When it is too small, use a baby fly or a twisted dry cotton that you gently introduce into the nose and remove gently.
  • Eliminate the moisture of the ears every time you wet them. Use a hair dryer instead. Hot air dries the ear, destroying wet conditions that promote the proliferation of bacteria and fungi.
  • Avoid excessive use of cotton swabs to clean the external ear canal, as this weakens the earwax (cerumen). It is necessary to remove the excess of earwax but not too much, because earwax performs several functions: it serves to transport beneficial bacteria and lines the auditory canal and protects it from moisture.
  • Wear earplugs before swimming, these balls will prevent water from entering the ears.
  • It is advisable to abstain from smoking near the child, and to keep the air clean and healthy.
  • Avoid excess or insufficient home or car heating.
  • Avoid swimming pools if you are subject to otitis; Swimming pools promote the transmission of infections, especially ear infections. On the contrary, sea baths are recommended.
  • Relieve pain by using heat: The heat of a towel that comes out of the dryer or a hot-water bottle can relieve the pain.
  • Use drops: Several fluids have an antibacterial effect while drying the ear. For example, rubbing alcohol: instill a few drops of alcohol into the ear canal, then stir the ear to spread the alcohol to the bottom of the ear canal. This will protect the ear from bacteria.
  • Another solution is the use of white vinegar, instill a few drops of white vinegar into the ear, this has the effect of killing bacteria and fungi.

7. When to Call Your Doctor?

ear infections - otitis

It is necessary to consult you doctor if:

  • If earache is accompanied by high fever, tremors or convulsions.
  • If earaches are accompanied by a big decrease in hearing capacity and dizziness.
  • If lot of liquid (blood or pus, for example) flows from the ear.
  • If the pain is very intense.
  • If the person is already suffering from a lesion to the ear (eg a perforated eardrum).



We have seen the minimum to know about ear infections or otitis, their causes and their types. You now know that these infections can degenerate and lead to serious consequences on hearing if they are not well cared for. You have also been given some tips to react quickly to ear infections and how to avoid them. We will present in a next article some natural remedies for these infections.



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