This is a common ear condition, especially in young children. It is an infection of the space behind the ear drum (middle ear).

This condition should be suspected in a child with a fever who is also pulling at an ear or specifically complaining of pain in an ear. In some cases, the ear begins to leak (discharge) after a few days of pain.

This condition tends to follow a minor cold-like illness and in most cases is likely caused by movement of viruses or bacteria from the nose to the middle ear.

Since acute otitis media is a viral infection in most cases, it tends to last a few days and then disappear. In some cases, acute otitis media may be caused by a bacteria, but even these often heal themselves in a few days. Rarely, the infections fails to improve by itself and treatment is required.

Your body's immune system will mount a strong response to this infection over 3-5 days and lead to complete cure in 9 out of 10 patients.

The main aim of treatment is to reduce the pain and fever associated with the condition, whilst your body is overcoming the infection. Painkillers like paracetamol can do both and are safe in both children and adults.

Whilst there have been no medical studies for the following, many patients/ families report good pain relief from the following non medical options:

1. Warm or cold compresses over the painful ear for 10 minute intervals. These can be alternated or used in isolation depending on which works best for the patient.

2. Body temperature olive oil drops into the painful ear canal

3. Garlic or ginger infused olive oil rubbed on the outer ear (not into the ear canal)

4. Sleeping with the painfull ear up

You should seek help if you are concerned. Or, you/your child develops any of the following:

1. The pain and fever continue despite the above painkillers

2. The symptoms are progressively getting worse after 2 days

3. The ear is discharging

4. Swelling or redness has occurred onto the outer ear or surrounding skin

5. The patient is drowsy during normal waking hours

6. Movements of the face become uneven, with the painful side being weaker

6. The condition keeps recurring

Your doctor/specialist will conduct an ear examination and decide on treatment. This may include a prescription of oral antibiotics.

In young children (under 6 years) it is normal to have between 4-11 cold-like infections a year. This is because the immune system is still immature and learning how to protect the body.

Since these infections occur sometimes in the ears (acute otitis media), sometimes in the nose (blocked or runny nose) and sometimes in the throat (tonsillitis or cough), they tend to be noticed less. When they occur at the same site, over and over again, they become more noticeable. In most cases they are still the result of a maturing immune system, and will improve with age.

That said, it is important you seek help from an ENT specialist to make sure there is no abnormality of the ear that is making your child more susceptible to ear infections.

There are not enough studies to know what the best treatment is. As such, there is little agreement between specialists on how to treat this. It is important that patients are aware of the thinking in these cases to help them make the best decisions for their children.

In some children who are requiring antibiotics frequently for ear infections, an ENT surgeon may advocate the insertion of a grommet.

This does not prevent or cure acute otitis media. Rather it allows the infection to escape through the grommet early, rather than build up and cause pain and fever. A consequence of this procedure is potentially more leaking from the ear hole.

Some ENT surgeons may advocate an adenoidectomy with this procedure, especially if they find grotty adenoids at the back of the nose. The thinking here is that in some children the adenoids have become a reservoir of bacteria, making infections more likely to develop. Removing the adenoids reduces the reservoir of bacteria, in turn reducing the chance of ear infections. Adding adenoidectomy to an operation adds time under general anaesthesia and some additional risks, which should be taken into consideration.