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Middle Ear Infection (Adults) - Types, Symptoms, Causes, Diagnosis, Treatment, and Prevention

Written by
Dr. Sneha Kannan
and medically reviewed by Dr. Nilotpal Dutta

Published on Nov 04, 2019   -  5 min read



Middle ear infection or otitis media not only affects children but can affect adults too. It can cause severe ear pain and fever, and sometimes require treatment. Read the article to know about its symptoms, causes, types, diagnosis, and treatment options.

Middle Ear Infection (Adults) - Types, Symptoms, Causes, Diagnosis, Treatment, and Prevention


Did you know your ear has three different sections? These sections work together to collect sounds and help us hear by sending these sound signals to the brain. The sections of the ear are:

  1. Outer ear - It consists of the pinna or auricle (the outer part of the ear that you see) and the ear canal (the part that connects the pinna to the middle ear). It works by collecting sounds and transporting them to the middle ear.

  2. Middle ear - The eardrum or the tympanic membrane separates the outer ear from the middle ear. When sound enters the middle ear, it hits this membrane and produces vibrations. These vibrations move the three small bones (malleus, incus, stapes) present in the middle ear called ossicles.

  3. Inner ear - It consists of the cochlea and semicircular canals. This part of the ear converts the vibrations into nerve signals.

human ear

image source : hearinglink

Do Adults Get Ear Infections?

Ear infections more common in children than adults. But ear infections in adults can be more severe. With proper treatment, most complications can be avoided. Some factors increase the risk of ear infections, but these factors can be avoided.

What Is a Middle Ear Infection?

Middle ear infection, otherwise called otitis media, is an infection behind the eardrum or the tympanic membrane. It occurs in conditions that prevent fluid from draining from the middle ear like allergies, cold, sore throat, or upper respiratory tract infection. They are more common in children but can occur in adults also. As it can be a serious problem in adults, additional tests might be required. If you keep getting ear pain and infection, it is best you consult an ENT otolaryngologist online.

What Are the Types of Otitis Media or Middle Ear Infection?

The types of middle ear infections include:

  • Acute otitis media - Here, the infection causes sudden redness and swelling of the inner ear. It results from fluid and pus getting trapped under the eardrum. It causes severe ear pain and fever.

  • Otitis media with effusion - It is otherwise called serous otitis media, as it results in fluid and mucus buildup in the middle ear after the infection resolves. It makes the middle ear feel heavy and full.

  • Chronic otitis media with effusion - Sometimes, fluid and mucus buildup remains in the middle ear for a long time or keeps building up repeatedly. There is no active infection, but this can affect your hearing.

What Are the Symptoms of a Middle Ear Infection in Adults?

The common symptoms of a middle ear infection in adults are:

  • Ear pain.

  • Fever.

  • Muffled hearing.

  • Sore throat.

  • Nausea and vomiting.

  • Ringing in the ear (tinnitus).

  • Fluid or pus discharge from the ear.

  • Feeling of fullness in the ear.

  • Hearing loss.

  • Loss of balance.

What Are the Causes of a Middle Ear Infection?

Any irritation in the eustachian tube, which is the tube that connects the middle ear to the throat, causes the area around it to swell. The eustachian tube regulates the pressure between the outer and inner ear. When a cold or allergy irritates this tube, fluids start draining from the middle ear. This fluid collects behind the eardrum, which facilitates the growth of bacteria and viruses.

Viruses are the most common cause of a middle ear infection, and the common viruses include influenza, herpes viruses, Epstein-Barr virus, and poliovirus.

How to Diagnose a Middle Ear Infection?

Your doctor will take a medical history and do a physical examination. Using an instrument called an otoscope, the doctor will look at the outer ear and eardrum for redness, swelling, and collection of pus or fluid. To check how well your eardrum moves, a pneumatic otoscope is used to blow a puff of air into the ear. If the tympanic membrane does not move well, it indicates fluid behind it.

To check if your middle ear is working properly, you might have to get a test called tympanometry. Here, a device is used to change the ear pressure and make the eardrum vibrate.

An audiogram or a tuning fork can also be used to test your hearing.

What Are the Treatment Options for a Middle Ear Infection?

Mild infections clear on their own sometimes. The treatment will depend on the cause and severity of the infection. The treatment options include:


  • Antibiotics - Antibiotic eardrops are used for bacterial ear infections, but it is not effective against viral infections. Oral antibiotics to treat ear infections are generally not recommended for middle and outer ear infections.

  • Analgesic ear drops - Your doctor might also prescribe eardrops containing painkillers like Acetaminophen Ibuprofen.

  • Decongestants or antihistamines - Pseudoephedrine or Diphenhydramine may help relieve caused mucus buildup in the eustachian tubes.

Home Remedies:

  • Applying warm compress on the ear may ease the pain.

  • To drain the ear, stand or keep your head upright while sitting.

  • For sore throat and to clear the eustachian tubes, try gargling with salt water.

  • Avoid smoking and alcohol intake.

  • Manage stress, as it can worsen symptoms of ear infection.

  • Garlic oil, tea tree oil, apple cider vinegar, basil oil, olive oil, and hydrogen peroxide are also used as eardrops to treat ear infections. There is no scientific proof if this helps, so always consult your doctor before using any oil.

What Are the Complications of a Middle Ear Infection?

An untreated ear infection can lead to:

  • Infection of the bones in the middle ear.

  • Infection of the CSF (cerebrospinal fluid) that surrounds the brain and spinal cord.

  • Permanent hearing loss.

  • Perforations or ruptured eardrums.

How to Prevent a Middle Ear Infection?

Some of the ways to prevent middle ear infections are:

  • Wash your hands frequently to prevent viral and bacterial infections.

  • Avoid smoking.

  • Avoid going out in a dusty environment.

  • Avoid using q-tips, as it pushes the wax inside the middle ear.

If you are suffering from ear pain for a long time, it is best you consult an ENT otolaryngologist online now!


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Last reviewed at:
04 Nov 2019  -  5 min read




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