Otitis media in teenagers

Overview

Otitis media is an infection or inflammation of the middle ear, which is the space just behind the eardrum. It can cause pain, temporary hearing loss, and sometimes fluid buildup.

No, otitis media is less common in teenagers than in younger children, but it still affects some teenagers.

Teenagers, especially those who have had ear infections before, have allergies, or have a weakened immune system.

Symptoms

Common symptoms

• Ear pain or aching
• A feeling of fullness or pressure in the ear
• Temporary hearing loss or muffled sounds
• Fever
• Irritability or trouble sleeping

Symptoms in children

• Tugging or pulling at the ear
• Crying more than usual
• Trouble sleeping or lying flat
• Loss of appetite
• Balance problems

Symptoms in older adults

• Similar symptoms of ear pain and hearing loss
• May also experience dizziness or balance issues
• Symptoms may be less specific, like confusion or a feeling of being unwell

Causes

Main causes

• Viral infection (often after a cold or flu), which can cause swelling and blockage of the eustachian tube
• Bacterial infection, sometimes following a viral infection

Risk factors

• Allergies that cause nasal congestion
• Exposure to tobacco smoke (secondhand smoke)
• Previous ear infections
• Weakened immune system
• Being around others with colds or flu

When to see a doctor

See a doctor urgently if:

• Severe ear pain that does not go away
• Fever over 102°F (39°C)
• Discharge from the ear
• Sudden hearing loss
• Dizziness or vertigo

Book a routine appointment if:

• Mild ear pain that lasts more than 2 days
• A feeling of fullness in the ear that does not improve
• Mild hearing loss that persists

Diagnosis

A doctor will look into your ear with a handheld light tool called an otoscope. This lets them check for redness, fluid behind the eardrum, or a bulging eardrum.

Tests that may be done

• Tympanometry – a gentle puff of air tests how well the eardrum moves
• Hearing test (audiometry) if hearing loss is a concern

What to expect at your appointment

The exam is quick and usually not painful. The doctor may also check your throat and sinuses. They will ask about your symptoms and any recent illnesses.

Treatment

Treatment depends on whether the infection is likely viral or bacterial and how severe your symptoms are. Many cases clear up on their own. Pain relief and home care are often the first steps.

Self-care at home

• Get plenty of rest
• Drink lots of fluids
• Use a warm compress or cloth on the outside of your ear for comfort
• Take over-the-counter pain relievers – ask your doctor or pharmacist which type is best for you
• Avoid getting water in your ear if there is discharge

Medical treatments

If a bacterial infection is confirmed, your doctor may prescribe antibiotics, usually taken for 5 to 7 days. It's important to finish the entire course even if you feel better. Occasionally, decongestants or nasal sprays may be recommended to help open the eustachian tube, but these are not a cure.

When is surgery considered?

Surgery is rarely needed for teenagers. In cases of frequent or long-lasting infections with fluid buildup, a small tube called a grommet may be inserted into the eardrum to drain fluid and improve hearing. This is done by an ear, nose, and throat (ENT) specialist.

Living with this condition

Most teenagers with otitis media recover fully. You may need to stay home from school if you have pain or fever. Avoid swimming, diving, or flying until your ear feels better and your doctor says it's safe.

Lifestyle tips

• Avoid smoking and being around secondhand smoke
• Manage allergies with the help of a doctor
• Keep your ears dry when bathing – use a cotton ball with petroleum jelly to block the ear if needed

Diet and exercise

Eat a balanced diet rich in fruits and vegetables to support your immune system. You can return to normal exercise as soon as your symptoms improve.

Mental health and emotional wellbeing

Ear pain and temporary hearing loss can be frustrating. It may affect concentration at school or make it hard to enjoy activities. It's normal to feel annoyed or worried. Talk to a parent or doctor if these feelings last.

Prevention

Not all ear infections can be prevented, but you can lower your risk. Avoid tobacco smoke. Get recommended vaccines. Manage allergies and sinus problems. Wash your hands often to reduce the spread of colds and flu.

Vaccines

The flu vaccine (given every year) and the pneumococcal vaccine can help prevent some infections that lead to otitis media. Talk to your doctor or nurse about whether these are right for you.

Complications

If left untreated

• Perforation (hole) in the eardrum – usually heals on its own but may take time
• Mastoiditis – infection of the bone behind the ear, which needs medical treatment
• Long-lasting hearing loss – usually temporary, but can become permanent if severe or repeated infections are not treated

Long-term outlook

With proper care, most teenagers recover fully within a week or two. Even if complications occur, treatment is very effective. Your doctor will help you manage symptoms and prevent future problems. The outlook is very good.

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