Ear Pain with Discharge (Acute Otitis Media) The ‘middle ear’ is the space behind the eardrum. In health, it is an air filled cavity which connects to the back of the throat (the nasopharynx) by a tube (The Eustachian tube). The tube opens when we swallow and allows the air pressure behind the eardrum to equalise with atmospheric pressure. We are sometimes aware of this when our ears pop, or when going up or down in an aeroplane.

Children in particular often have problems with this tube opening and sometimes with bacteria travelling up the tube from the throat and nose. When this happens infection can rapidly take hold in the middle ear leading to the accumulation of pus.

Symptoms typically occur during or shortly after a cold. In very young children they may rub or pull on the ear. Older children will say the ear is painful. The pain often becomes severe as the pressure of fluid within the middle ear causes the very sensitive eardrum to bulge outwards. If antibiotics are given at this stage the infection usually abates. Sometimes however, the eardrum bursts releasing a stream of pus from the ear. When this occurs the pain tends to rapidly subside as the pressure on the eardrum is relieved.

A typical history is of a child obviously in pain who responds, but not completely to Calpol. When put to bed, the child is usually still upset with pain but stops crying when the eardrum bursts and the infection is released. Parents often say that on visiting the bedroom, their son or daughter looks much more comfortable and there is a patch of infected debris on the pillow next to the ear.

In repeated episodes of acute otitis media (Recurrent Acute Otitis Media) it is sometimes necessary to prescribe a long course of antibiotics. If this fails to resolve the problem, the insertion of grommets ( small tubes which sit in the eardrums) is usually effective.

Most children grow out of this condition as the immune system matures and long term treatment of this problem past the age of ten is very unusual.

If you would like to arrange a consultation with Mr Banerjee to look into this condition further please contact us.

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