Dr David Lowinger MBBS FRACS Ear Nose & Throat Specialist Surgeon
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Ear Infection

Ear is comprised of outer ear, middle ear, and inner ear. Eustachian tube or auditory tube connects the middle ear to the throat. It helps to clear the mucous from the middle ear. Infection can affect ear canal (otitis externa), ear drum, or the middle ear. Children are prone to get ear infection than the adults because of their weak immune system.

The most common infection in children is the middle ear infection (otitis media). When your child develops cold, allergy, or upper respiratory tract infection, the bacteria or virus spreads to ear causing infection, pus or mucous formation in the ear drum and blockade of the eustachian tube. Infection causes pain and swelling. In children, the eustachian tube is smaller and therefore draining out the pus becomes difficult. During an infection, the bacteria infect the adenoid glands and cause chronic infection. Adenoid glands are glands located at the back of the nose and throat that fights against the bacteria and other germs invading the body.


Bacterial infections, sore throat, and upper respiratory tract infections are the main causes for ear infections. The infective organisms in these conditions spread to ear causing ear infections. Other causes include excess mucous and saliva produced during teething, cold, allergies, overgrown adenoids, and tobacco smoke or any irritants.

Children who sip more often from sippy cup lying on back are more prone to develop ear infections. Other risk factors include exposure to cold weather and smoke, recent ear infection, not being breastfed, and familial history.


Children with ear infection may have symptoms such as troubled sleep, fluid draining from the ear, fever, fussiness, tugging or pulling the ear, vomiting, and trouble in responding to quiet sounds.


Your doctor will ask about your child’s medical history and perform a physical examination of ears, throat, head, and neck. Using otoscope, a lighted instrument, your doctor will look inside your child's ear for a red bulge, air bubbles, or fluid which are the symptoms of infection.

Pneumatic otoscope test may also be performed. Your doctor blows air into your child's ear; in normal cases the ear drum moves front and back when air is blown, but in an infected ear, the ear drum does not move, which indicates that fluid is present.

Your doctor may suggest for a hearing test in children who have frequent ear infections.


Antibiotics remain the main stay of treatment for ear infections where antibiotics eradicate the bacteria responsible for infections and provide relief.

Surgical treatment is considered if the antibiotic therapy is not successful or in cases of recurrence. In this procedure your surgeon will place tympanostomy tube, a small ventilating tube in the eardrum. This tube prevents fluid accumulation in the ear by draining out the fluid and allowing air to pass into the middle ear.

Complications of ear infection

Ear infections, if left untreated may cause several complications. These complications include meningitis, chronic and recurrent infections, formation of cysts, enlarged adenoid glands, spread of infections to brain tissues, delay in speech and hearing loss. Therefore early diagnosis and treatment will prevent your child from developing further complications.


Practicing certain measures may prevent your child from developing infections.

  • Vaccinate your child against the flu every year with vaccines for Streptococcus pneumoniae and Hemophilus influenzae
  • Encourage and educate your child on hygiene and good health practices
  • Avoid exposure to cigarette smoke
  • Ensure your child stays away from infected children
  • Avoid your child from sleeping on floor
  • Avoid overuse of antibiotics
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Royal Australasian College of Surgeons The Australian Society Of Otolaryngology Head And Neck Surgery Australian New Zealand Society of Paediatric Otorhinolaryngology (ANZSPO) The University of New South Wales The University of Sydney Harvard Medical School

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