Ear infections, specifically infections of the middle ear, are common childhood infections in industrialized countries and the leading cause of outpatient antimicrobial treatment of children in the United States. Infections of the middle and inner ear can cause temporary or permanent loss of hearing and associated speech and language delays. The World Health Organization estimates that in developing countries, 51,000 children under 5 years of age die annually from complications of infections of the middle ear. There are three types of ear infections characterized by location in the ear.
Infection of the middle ear is known as otitis media and is characterized by infected fluid behind the eardrum. Otitis is the Latin word for inflammation of the ear. The eardrum separates the inner ear from the ear canal. Infections of the middle ear are defined by acute otitis media, a middle ear infection with both effusion, or fluid, and presence of signs or symptoms of an acute infection, or by otitis media with effusion, a middle ear infection with effusion and without signs or symptoms of an acute infection.
Signs and symptoms of acute otitis media include pulling of the ear in an infant, irritability in an infant or toddler, discharge from the external ear, and fever. By 3 years of age, 50 to 85 percent of children in the United States have had acute otitis media with peak incidence between ages 6 and 11 months. Recurrent acute otitis media infections, defined as three or more episodes of infection, affect 10 to 20 percent of children by 1 year of age. Children with recurrent acute otitis media infections may have a surgical treatment, myringotomy, whereby a small tube is placed inside the affected ear by an otolaryngologist. Infections of the middle ear are caused by Eustachian-tube dysfunction...