Otitis media is a painful inflammation of the middle ear, the area directly behind the eardrum. When a person has a common cold, the Eustachian tube can get closed, allowing bacteria and inflammatory fluid to get stuck in the middle ear. The pressure increases and the eardrum will bulge. Otitis media, as well as otitis externa, falls under the heading of ‘ear infection’.


Between the middle ear and the nasopharynx runs a little canal, the Eustachian tube. Fluid from the middle ear can get through the Eustachian tube to the nasopharynx. Otitis media usually begins with a common cold. The Eustachian tube can thus be closed. In most cases, the inflammation is caused by bacteria. It’s unclear whether viruses can cause otitis media. However, it is suspected that viruses, due to the resulting inflammatory response, stimulate susceptibility to bacterial infection of the middle ear. A few hours after infection, the first symptoms will occur.


Otitis media is often accompanied by earache, malaise, fever and a runny ear. In case of a runny ear, the eardrum tears and there may be blood and pus coming out of the ear, thereby reducing pain. Very young children are not yet able to pinpoint the location of the pain. The symptoms in a young child are fever and crying. Older children may indicate that they have earache, rub or pull the painful ear and temporarily hear bad with the inflamed ear.


Inspection of the ear shows a red and protruding (bulging) eardrum. The ear canal and the eardrum can be examined with an otoscope. This is a device that illuminates and magnifies the inside of the ear. The doctor looks whether there is pus in the middle ear.


Otitis media can hurt a lot. The doctor will usually prescribe painkillers. In case of severe pain, the eardrum may be punctured. If there’s a stuffy nose, nasal drops can be prescribed. There may also be decided to give antibiotics. With proper treatment, the symptoms are usually gone within a few days. A teared eardrum is healed within a few weeks. If otitis media recurs and doesn’t respond to antibiotics, placing tympanostomy tubes may be considered, optionally in combination with removing the tonsils.


Ninety percent of the cases of acute otitis media heal within three days. Sometimes, a runny ear occurs. A runny ear usually heals spontaneously within two weeks. Checking is not necessary then. Complications are rare. The most serious complications are infection of the bone behind the ear (mastoiditis) and meningitis. Then, the child is increasingly seriously ill.