Otitis media is a bacterial infection of the middle ear. The middle ear is a cavity that contains three tiny bones that transmit the vibrations of the eardrum to the hearing mechanism in the inner ear. There is a small tube (the Eustachian tube) connecting the middle ear to the back of the nose, and infection can enter the middle ear from there. Infection can also spread from the outer ear to the middle ear. Children are more commonly affected than adults.
Patients experience a sudden onset of severe pain, often at night, and a fever. Pressure on the outside of the ear causes additional pain and relative deafness.
Antibiotics and medications are prescribed to dry up phlegm, but it is sometimes necessary to perform a small operation on the eardrum to relieve the pressure. If left untreated or there is rapid worsening of the infection, the bulging eardrum may burst, and blood and pus will ooze out of the ear canal. The pain may be relieved by rupture of the eardrum, but treatment with antibiotics is essential to ensure that the eardrum repairs itself. If the hole in the eardrum fails to heal after several months, it may be necessary to have an operation to repair it. Rarer complications include a spread of the infection into the surrounding bone (mastoiditis), or into the bloodstream or brain.
Patients get very good results with appropriate treatment, and a ruptured eardrum usually heals in one or two weeks.