Role of adenoids
Adenoids are two small pads of tissues high in the back of the nose believed to play a role in immune system activity. This function may make them particularly vulnerable to infection, inflammation and swelling.
Because adenoids are near the opening of the eustachian tubes, inflammation or enlargement of the adenoids may block the tubes, thereby contributing to middle ear infection. Inflammation of adenoids is more likely to play a role in ear infections in children because children have relatively larger adenoids.
Conditions of the middle ear that may be related to an ear infection or result in similar middle ear problems include the following:
- Otitis media with effusion is inflammation and fluid buildup (effusion) in the middle ear without bacterial or viral infection. This may occur because the fluid buildup persists after an ear infection has resolved. It may also occur because of some dysfunction or noninfectious blockage of the eustachian tubes.
- Chronic otitis media with effusion occurs when fluid remains in the middle ear and continues to return without bacterial or viral infection. This makes children susceptible to new ear infections, and may affect hearing.
- Chronic suppurative otitis media is a persistent ear infection that often results in tearing or perforation of the eardrum.
Risk factors for ear infections include:
- Age. Children between the ages of 6 months and 2 years are more susceptible to ear infections because of the size and shape of their eustachian tubes and because of their poorly developed immune systems.
- Group child care. Children cared for in group settings are more likely to get colds and ear infections than are children who stay home because they’re exposed to more infections, such as the common cold.
- Infant feeding. Babies who drink from a bottle, especially while lying down, tend to have more ear infections than do babies who are breast-fed.
- Seasonal factors. Ear infections are most common during the fall and winter when colds and flu are prevalent. People with seasonal allergies may have a greater risk of ear infections during seasonal high pollen counts.
- Poor air quality. Exposure to tobacco smoke or high levels of air pollution can increase the risk of ear infection.
Most ear infections don’t cause long-term complications. Frequent or persistent infections and persistent fluid buildup can result in some serious complications:
- Impaired hearing. Mild hearing loss that comes and goes is fairly common with an ear infection, but it usually returns to what it was before the infection after the infection clears. Persistent infection or persistent fluids in the middle ear may result in more significant hearing loss. If there is some permanent damage to the eardrum or other middle ear structures, permanent hearing loss may occur.
- Speech or developmental delays. If hearing is temporarily or permanently impaired in infants and toddlers, they may experience delays in speech, social and developmental skills.
- Spread of infection. Untreated infections or infections that don’t respond well to treatment can spread to nearby tissues. Infection of the mastoid, the bony protrusion behind the ear, is called mastoiditis. This infection can result in damage to the bone and the formation of pus-filled cysts. Rarely, serious middle ear infections spread to other tissues in the skull, including the brain or the membranes surrounding the brain (meningitis).
- Tearing of the eardrum. Most eardrum tears heal within 72 hours. In some cases, surgical repair is needed.
The following tips may reduce the risk of developing ear infections:
- Prevent common colds and other illnesses. Teach your children to wash their hands frequently and thoroughly and to not share eating and drinking utensils. Teach your children to cough or sneeze into their arm crook. If possible, limit the time your child spends in group child care. A child care setting with fewer children may help. Try to keep your child home from child care or school when ill.
- Avoid secondhand smoke. Make sure that no one smokes in your home. Away from home, stay in smoke-free environments.
- Breast-feed your baby. If possible, breast-feed your baby for at least six months. Breast milk contains antibodies that may offer protection from ear infections.
- If you bottle-feed, hold your baby in an upright position. Avoid propping a bottle in your baby’s mouth while he or she is lying down. Don’t put bottles in the crib with your baby.
- Talk to your doctor about vaccinations. Ask your doctor about what vaccinations are appropriate for your child. Seasonal flu shots, pneumococcal and other bacterial vaccines may help prevent ear infections.