Ear pain can interrupt sleep and everyday activities, particularly in children. Otitis media affects the middle ear, the space behind the eardrum. A medical assessment helps distinguish an acute infection from fluid in the middle ear or another cause of earache.
What is otitis media?
Middle ear problems commonly occur during or after a respiratory infection. The main forms include:
- Acute otitis media: an infection with a relatively sudden onset of ear pain and sometimes fever.
- Otitis media with effusion: fluid behind the eardrum without signs of an acute infection, often called glue ear. It can affect hearing.
- Chronic suppurative otitis media: persistent or recurrent ear discharge through a perforated eardrum, requiring medical assessment.
How is it diagnosed?
The doctor asks about symptoms and examines the ear with an otoscope. This examination is important because ear pain alone does not establish the diagnosis. Hearing tests, tympanometry or an ear, nose and throat specialist assessment may be needed when fluid, hearing changes or recurrent problems persist.
A video consultation can help assess symptoms and organise appropriate care, but it cannot replace an examination of the eardrum when one is required.
Treatment depends on the findings
Many uncomplicated acute infections improve without antibiotics. Depending on the examination, age, severity and risk of complications, the doctor may recommend observation with follow-up, a delayed prescription or immediate treatment. Do not start leftover antibiotics or use someone else’s prescription.
Ask a doctor or pharmacist about pain relief suitable for the patient’s age and medical history. Persistent middle ear fluid or hearing problems may need monitoring and specialist care; some patients benefit from ventilation tubes after an individual assessment.
Decongestants and oral or nasal corticosteroids are not recommended to treat otitis media with effusion in children. A separate nasal condition may require its own assessment.
When to seek medical help
Seek prompt medical advice for worsening symptoms, ear discharge, new hearing loss, marked dizziness or a patient who is generally unwell. Swelling, redness or severe tenderness behind the ear, or severe uncontrolled pain, requires urgent in-person assessment.
For immediate danger or a suspected medical emergency in Italy, call 112. Doc On Call does not replace emergency services.
Prevention and follow-up
Hand hygiene, avoiding exposure to tobacco smoke and keeping recommended vaccinations up to date can help reduce infection risks. Attend follow-up if symptoms or hearing difficulties persist. Do not put cotton buds or other objects inside the ear.
For an assessment at home in Rome or Rimini, see our doctor home visit service. Availability is confirmed for the exact address.