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Common in children and usually self-healing — pain relief comes first.
Also known as: middle ear infection · otitis media
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Especially common in small children, because their connection between ear and throat is short and flat and gets blocked with every cold. Typical: sudden, stabbing earache, often at night, fever, reduced hearing, and in small children crying, grabbing the ear and restlessness. If fluid suddenly runs from the ear and the pain stops abruptly, the eardrum has usually perforated — this normally heals on its own. Many cases improve within one to two days without antibiotics, so waiting while treating the pain is often the first step. It should still be assessed, especially in infants, with high fever, both ears affected, or if it does not improve.
Place a cherry stone cushion or a warm compress at hand warmth for 15 to 20 minutes, with the head raised when lying down.
In children over two with a one-sided finding and a good general state, two days of waiting while treating only the pain is common. A standby prescription in case things get worse goes with it.
Paracetamol or ibuprofen in a sufficient dose matched to weight works reliably here. In this illness that is the measure that helps the child fastest.
Swelling or redness behind the ear, an ear that sticks out, high fever, severe headache or a very drowsy child: that belongs looked at at once and is the exception to waiting.
A sudden easing of the pain with discharge in the ear canal usually means a small tear. It normally heals by itself; the important thing is to keep the ear dry and have it checked again.
If fluid stays behind the eardrum the child hears as if muffled — in everyday life that often shows as inattention, not as hearing loss. With repeated infections a hearing test belongs with it.
In about eight out of ten children the symptoms improve within two to three days even without an antibiotic. So waiting with a back-up prescription is common. Fluid behind the eardrum afterwards can dampen hearing for weeks to months without hurting.
A painkiller is the most important treatment here and works within thirty to sixty minutes. An antibiotic shortens the pain by about a day and changes nothing else for most — in children over two without a severe general state, two days of waiting with a back-up prescription is common. Ear drops do not reach the middle ear as long as the eardrum is closed. Decongestant nose drops achieved nothing in studies.
Chop an onion small and warm it briefly to hand temperature — in a dry pan or over steam, not fried.
Stabbing, throbbing pain, often worse lying down, usually one to three days after a cold. Small children hold their ear, are restless and do not want to drink.
A feeling like cotton wool in the ear, one’s own voice sounds hollow, with fever. The muffled hearing can last weeks after the pain has gone.
A sudden easing of the pain with fluid in the ear canal usually means a small tear in the eardrum. It normally heals by itself — the ear stays dry.
Swelling or redness behind the ear, an ear that sticks out, a stiff neck, a drooping half of the face or a very drowsy child. These are the signs that belong looked at at once.
For an ordinary middle ear infection no blood values are needed — looking at the eardrum makes the diagnosis. This value belongs alongside when the child is very unwell.
Belongs alongside with a suspected spread: a protruding ear, redness and tenderness behind the ear, a high fever.
Fever, sweating and faster breathing clearly raise the need. Drinking enough keeps the mucus thin and the circulation steady — in children and older people it is the most important point of all.
With low levels airway infections occur somewhat more often; correcting a deficiency makes sense, a high single dose during the infection does not act on it.
Needed by the defence cells. For lozenges at the start of a cold there are hints of a slightly shortened duration; at a high dose over months zinc lowers copper.
Antibodies and defence cells are protein. After several days with little appetite it is worth at least keeping the protein up — soup with egg, quark, yoghurt, lentils.
Most middle ear infections heal by themselves — in children over two without a severe sense of illness, waiting 48 hours is a recognised route. What counts in that time is sufficient pain relief, not a preparation.
In children with repeatedly recurring middle ear infections a controlled trial found fewer new cases under daily vitamin D — the effect was there where the starting level was low. At a normal level more brings nothing.
For some strains in the nose and throat a small reduction in recurring cases is described. The effect is weak, strain-dependent and disappears when the taking stops — unlike passive smoke, whose removal brings the largest single improvement.
Cortisone brings no lasting benefit with fluid behind the eardrum — it comes back after stopping. What works in studies is time: three months of waiting resolves the majority of cases by itself.
In children with recurrent middle ear infections a small study with vitamin D over four months showed fewer relapses. The finding has stood alone — it is a pointer, not a standard.
In infants drinking from a bottle while lying down increases the frequency of middle ear infections. Feeding semi-upright is one of the few established preventive measures.