Otitis media means inflammation of the middle ear. The phrase comes from the Latin words 'oto-' meaning 'ear' and 'medius' meaning 'middle'. It is usually caused by an infection and is the most common cause of earache, especially in young children.

The Structure Of The Ear

The ear is made up of three different sections: the outer ear, the middle ear and the inner ear. The outer ear is made up of the ear trumpet and the auditory canal (the visible parts of the ear structure). The middle ear is an air cavity separated from the outer ear by the ear drum. It contains a link of three small bones, commonly known as the hammer, anvil and stirrup because of their shape. The inner ear consists of fluid-filled cavities known as the cochlea and the semi-circular canals.

How Does The Ear Work?

The ears have two different functions: they enable us to hear and they control our balance.The ear trumpet collects sound waves and channels them along the auditory canal to the ear drum which then vibrates. This moves the bones in the middle ear which conduct the sound vibrations to the cochlea in the inner ear. The cochlea is lined with tiny hairs which move in response to sound vibrations. The moving hairs trigger nerve impulses which send messages to the brain so that we can detect sound.

The semi-circular canals in the inner ear help us to keep our balance. They detect movement of the head and send messages to the brain so that we can keep our balance.


If the middle ear becomes inflamed, a number of unpleasant symptoms can develop. The main signs of an ear infection include:

  • A severe, throbbing or stabbing pain in one or both of the ears
  • A high temperature
  • Loss of appetite
  • Irritability
  • Congestion
  • Feeling off colour

You may also notice:

  • Discharge from the ears
  • Gradual loss of hearing

Young children may not be able to tell you that they are in pain so if you notice children rubbing or tugging their ears or crying more than usual, they may have an ear infection. Ear infections in children can also be accompanied by diarrhoea and sickness.

Sometimes the Eustachian tube (the tube leading from the cavity behind the nose and mouth to the middle ear) can swell and become blocked. When a blockage occurs, fluid can accumulate causing the ear drum to perforate as pressure builds up.


Ear infections are often caused by viruses. They commonly occur after a cold, flu, mumps, measles or similar because viruses can easily spread from the nose, throat or sinuses into the ear via the Eustachian tube.Ear infections can also be caused by bacteria.

Children who suffer from asthma or eczema and those who are exposed to other people's tobacco smoke are more likely to develop otitis media. Infections are also more easily spread in closed environments therefore children who attend a day care establishment will be more at risk.


Ear infections usually clear up on their own without treatment. Do not poke inside your ear with a cotton bud as this can cause a perforated ear drum.Simple pain relief treatments containing paracetamol can help to ease pain and reduce fever. Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen can also be used to ease pain in adults.

Some people choose to take decongestants to clear congestion but they are not generally recommended.

Antihistamines are sometimes used to reduce swelling.

Ear drops containing mild pain killers, antibacterials or steroids can be used if prescribed by a doctor.

Antibiotics can only be used to treat ear infections caused by bacteria. They will not work if the ear infection is caused by a virus. They work by destroying the bacteria causing the infection.

When To See A Doctor

If your earache does not clear up after 24 hours, make an appointment to see your doctor.

Additional Information

Leaflets about colds, flu, how to use ear drops, passive smoking and giving up smoking are also available from any pharmacy.