An ear infection occurs when fluid builds up behind the eardrum, causing pain, pressure, temporary hearing loss, and fever, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). The NIDCD says that five out of six children will have at least one ear infection by their third birthday, and most of these are not serious. However, CHOC Children’s Hospital in Orange, California explains that if you or your child have three ear infections during a six-month period, or four within a year, this is the telltale sign of what’s known as a chronic or recurring infection — and, if left untreated, it could lead to permanent hearing loss. Determining the root cause of recurrent ear infections is the first step toward a cure. Common culprits may include allergies, chronic sinus problems, or an underdeveloped or blocked Eustachian tube, the passage that connects the middle ear to the upper part of your throat. Eustachian Tube Problems “In infants and toddlers, the Eustachian tube may not be mature or fully functional yet, so they can end up with negative pressure that causes the buildup of fluid and recurrent ear infections,” says Eugene Chio, MD, an otolaryngologist at The Ohio State University Wexner Medical Center in Columbus. “The ear drum is transparent, so we can see fluid or pus behind it, and sometimes, the ear drum itself is red or bulging from the pressure,” he adds. In these cases, especially if hearing loss is involved, ear tubes may be needed to drain the fluid and prevent further ear infections. “Ear tubes help equalize pressure and drain fluid, and they fall out within two years as the Eustachian tube matures,” Dr. Chio says. Each year, more than a half-million ear tube surgeries are performed on children, the American Academy of Otolaryngology – Head and Neck Surgery reports. Still, it’s a surgery and involves the use of general anesthesia, Choi notes. Allergies and Sinusitis “Chronic sinusitis or allergies are other potential causes of recurrent ear infections,” says Jordan S. Josephson, MD, an otolaryngologist at Lenox Hill Hospital in New York City and the author of Sinus Relief Now: The Groundbreaking 5-Step Program for Sinus, Allergy, and Asthma Sufferers. “In these cases, an antibiotic will treat the infection, but it won’t address the underlying susceptibility to ear infections,” Dr. Josephson says. And, because overuse of antibiotics can lead to resistance, pediatricians are often reluctant to prescribe antibiotics unless it’s absolutely necessary. In general, parents are told to observe the child for 48 to 72 hours and treat the pain with over-the-counter pain relievers, he adds. Prevention can also help you avoid more ear infections once the cause becomes clear, according to Josephson. If sinusitis is leading to ear infections, irrigating the sinus passages with a saline wash can make a difference, he says. Plus, keeping your immune system healthy can also help prevent some of the infections that lead to sinusitis and ear infections. “A computed tomography scan or other imaging tests can help diagnose sinusitis,” he notes, adding that getting tested for allergies and coming up with a plan to avoid exposure to irritants can also help. Why It’s Important to Treat Recurring Ear Infections If unaddressed and untreated, recurrent ear infections can lead to permanent hearing loss or a ruptured eardrum, Josephson says. You could also develop a cholesteatoma, an abnormal skin growth in the middle ear behind the eardrum, which can occur when the vacuum pressure during an ear infection stretches the eardrum, according to the American Academy of Otolaryngology – Head and Neck Surgery. “I’ve also seen kids who have had scar tissue, necrosis [dead tissue] or erosion of the bone behind the ear as a result of recurrent ear infections,” Chio says.
