Complications | Symptoms of acute otitis media


Complications that can occur in the course of an acute inflammation of the middle ear are usually recognised by specific symptoms. For example, the inflammation can affect not only the middle ear but also the inner ear, which is responsible for the transmission of sound information and for balance. Thus, an inflammation of the inner ear can become noticeable mainly through dizziness and total hearing loss on one side.

Another complication is meningitis, which is caused by an infection of the meninges. An infection of the middle ear can also cause a so-called brain abscess. This can lead to unspecific neurological-psychological failures, which require neurological diagnosis and should be detected quickly.

Another dreaded complication of acute middle ear inflammation is the so-called mastoiditis. This is the inflammation of the mastoid process of the temporal bone. Whether such an inflammation is present can be recognised mainly by severe pressure pain in the area behind the ear.

This area is often accompanied by swelling and a purulent secretion is discharged from the ear. Inflammation of the middle ear can affect nerves that are located near the middle ear and thus lead to temporary paralysis. This particularly affects the facial nerve (nervus facialis), which can paralyse areas of the face if it fails.

This becomes visible by a hanging corner of the mouth on one side and the inability to close one eyelid completely. Probably one of the most serious complications of acute middle ear infection is sepsis (colloquially known as blood poisoning), which is caused by a shift of the pathogens from the middle ear to the blood. Sepsis can be recognised by a pronounced shock symptomatology.

This includes rapid breathing, an increased heartbeat and an elevated body temperature. Frequent inflammation of the middle ear can damage the eardrum to such an extent that it scars. Since the eardrum plays a major role in amplifying the perceived sound, scarring of this structure is associated with permanent hearing loss. For this reason, frequent inflammation of the middle ear with a perforating eardrum should be prevented as far as possible.


The causes of the typical symptoms of acute otitis media lie in the body’s reaction to the colonisation by pathogens. In most cases of acute inflammation of the middle ear, bacteria are the cause of the infection, although viruses can also be responsible for the disease. The typical pathogens of an acute middle ear infection are also pathogens that typically cause infections of the respiratory tract in the human organism.

These are mainly bacterial pathogens such as streptococci, Morraxella catarrhalis, or haemophilus influenza, or viral pathogens such as the influenza virus or herpes viruses. The path of infection that pathogens take when they infect the middle ear is the pathway that connects the throat with the middle ear: the so-called auditory tube (Tuba auditiva). If this passage is swollen as a result of the infection, the middle ear or tympanic cavity can no longer be ventilated sufficiently, which leads to an accumulation of secretion in it. This accumulation of inflammatory secretion can explain a number of typical symptoms of acute middle ear inflammation.