Five things to know about ear infections
Ear infections can occur when the eustachian tube, which runs from the ear to the back of the nose, gets blocked. This can cause a middle ear infection, which can be painful. It’s common for kids experiencing ear infections to become fussy. Repeated ear infections can make parents fussy, too.
Ear infections are most common among children under age 3. In addition to pain, repeated ear infections can impact a child’s hearing and speech development.
Joshua Thom, MD, an otolaryngologist with M Health Fairview Pediatrics, shares five things to know about ear infections and answers some commonly asked questions about ear tubes.
Most ear infections are tied to an upper respiratory infection.
The Eustachian tube, which is located behind the eardrum and connects the middle ear to the back of the nose, is the usual culprit with childhood ear infections. When a nose is congested, the Eustachian tube can swell and become blocked, which can lead to a middle ear infection. One way to avoid ear infections is to avoid upper respiratory infections.
Unfortunately, it’s tough to prevent ear infections. Some children are more likely to get ear infections due to family history. Cleaning ears or avoiding swimming and water won’t prevent ear infections because the infection occurs behind the ear drum in the middle ear.
Second-hand smoke increases ear infection risk.
Young kids who are exposed to people who smoke are at increased risk of ear infections, even if the person only smokes outside or away from children. The smell and related particulate exposure from clothing, skin and hair can cause inflammation in the Eustachian tube and lead to infections, Thom said.
Ear infections can be painful.
Since ear infections are often tied to upper respiratory infections, kids often first have cold-like symptoms, such as a runny nose and cough. Those symptoms are often accompanied by:
Tugging or pulling at the ear
Ear pain, especially when lying down
Difficulty hearing
Fever
Fussiness
Difficulty sleeping
Fluid draining from the ear
“Some kids will have infections and they'll be relatively tolerant of it,” Thom said “They might not seem to be in pain. Other children will show signs of being very uncomfortable.”
You don’t always need to see a healthcare provider
If symptoms are mild, you may be able to watch and wait rather than going in to get diagnosed. Some ear infection symptoms will clear on their own. Thom recommends watching your child for a day or two and giving them ibuprofen or Tylenol if needed. Not all ear infection symptoms need to be treated with antibiotics.
But if your child’s symptoms worsen, go to urgent care or call their primary care provider. An ear infection can lead to a ruptured eardrum if the pressure builds up enough. A sign of a ruptured eardrum is fluid or pus draining from their ear. This often occurs along with pain and fever.
Ear tubes might help
The American Academy of Otolaryngology guidelines recommend ear tubes for people who have three or more diagnosed ear infections in six months, or four or more in a year. Ear tubes are hollow tubes that doctors insert through a tiny hole in the eardrum to help prevent fluid and infection buildup in the middle ear.
“Tubes are not 100% perfect,” Thom said. “The tubes greatly reduce kids’ number of infections, and many kids will have tubes and never give another ear infection. However, kids still can get ear infections with tubes.”
Here are some answers to common ear tube questions:
How long does the procedure take?
The procedure to insert ear tubes is fairly simple and is done in about 10 minutes, Thom said. Kids are generally given gas anesthesia in the operating room. Any fluid or infection is suctioned out of their middle ears before the tubes are slipped into place. Then kids recover for about 45 minutes before they can go home. Thom wants his patients to spend the rest of the day at home. They can go back to school, daycare, or their usual activities the following day. Once tubes are in place, kids can’t feel them.
How long do ear tubes last?
Ear tubes usually last one to two years. They will fall out on their own. At that point. Most kids will have outgrown the period when they’re at high risk of ear infections. A smaller number will go on to get another set of tubes.
The frequency of ear infections declines significantly after age 3. Thom does treat some teenagers or adult patients who continue to experience ear infections or fluid in the ears. For those patients, he can even put their tubes in right in the clinic without anesthesia.
“I put a little numbing medicine in teenagers’ or adults' ears that does sting a little bit but it's similar to a minor dental procedure,” Thom said.
Can people with ear tubes go swimming?
Clean water like in the shower or a chlorinated swimming pool is fine, Thom said. But use caution when swimming in a lake, ocean, or river. Wear ear plugs or keep your head above water. Because ear tubes create a little hole in the eardrum, tubes actually increase risk of ear infection if bacteria get in.
What are the risks of ear tubes?
Ear tubes are fairly low risk. One possible complication: They may fall out early and need to be replaced. Other times, they might not fall out when they should or slip further into the ear. If that occurs, a doctor can remove them. The eardrum might not fully close after the tube comes out, requiring repair of the ear drum in the future There is also risk of having a reaction to anesthesia.
If you’re concerned about ear infections, talk to your child’s primary care provider or schedule an appointment with our otolaryngology (ear, nose, and throat) specialists.
