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Middle Ear Problems

Is your child overly restless or cranky — maybe tugging on an ear or talking about his or her ears “making noises”? If so, your child may have a middle ear infection. In the early stages, these infections can be very painful. Sometimes, associated problems linger for months and affect hearing. But, despite their potential severity, middle ear problems respond well to treatment.

Illustration of a blocked tube

A Blocked Tube

Middle ear infections are usually caused by bacteria or viruses. In young children, these germs probably reach the middle ear by traveling the short length of the eustachian tube from the throat. Once in the middle ear, they multiply and spread. This irritates delicate tissues lining the middle ear and eustachian tube. If the eustachian tube lining swells enough to block off the tube, air pressure drops in the middle ear. This pulls the eardrum inward, making it stiffer and less able to transmit sound.

Illustration of fluid buildup in the ear causing pain

Fluid Buildup Causes Pain

Once the eustachian tube swells shut, moisture can’t drain from the middle ear. Fluid produced to flush out the infection builds up in the chamber. This may raise pressure behind the eardrum. As the infection spreads to this fluid, pressure behind the eardrum shoots way up. The eardrum is forced outward, becomes painful, and may break.

Illustration of chronic fluid affecting hearing

Chronic Fluid Affects Hearing

If the eardrum doesn’t break and the tube remains blocked, the fluid becomes chronic (an ongoing condition). As the acute (immediate) infection passes, the middle ear fluid thickens. It becomes sticky and takes up less space. Pressure drops in the middle ear once more. Inward suction stiffens the eardrum, affecting hearing. If the fluid is not removed, the eardrum may be stretched and damaged.


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