Signs of inflammation of the middle ear

An acute inflammation of the middle ear (Otitis media acuta) is a viral or bacterial inflammation. Viruses or bacteria migrate through the nasopharynx to the middle ear, where they cause inflammation. The signs of an inflammation of the middle ear can initially be non-specific.

In the case of an acute inflammation of the middle ear, the first symptom is severe ear pain, whereby the pain is usually localized on one side only, since the inflammation of the middle ear is often only one-sided. Some patients also experience increased pressure on the diseased side, and a knocking sound may be heard. Increased dizziness is also a typical first sign of an inflammation of the middle ear.

This is due to the fact that in our ear, in addition to the various ossicles and the “inner ear” for acoustic hearing, there is also our organ of balance, the so-called vestibular appendix. If a middle ear inflammation causes a slight constriction or false irritation of the organ of balance, this can lead to dizziness and possibly even a one-sided tendency to fall. In most cases, however, patients “only” feel a slight dizziness.

Since it is an inflammatory reaction in which viruses or bacteria are involved, the classic symptoms of inflammation are also present. Therefore, fever, night sweat and aching limbs can also be the first signs of an inflammation of the middle ear. In addition, the body defends itself with the innate immune system against the bacteria or viruses.

Therefore, in addition to pain in the middle ear, redness and swelling automatically occur, and there may also be warming in the area of the ear. The swelling can reduce the hearing impression or cause false noises in the ear (tinnitus). Since the middle ear is directly connected to the nose, the first sign of a middle ear infection can also simply be a harmless looking cold.

However, as soon as there is increased ear pain and an unpleasant feeling of pressure in the ear, the signs are clearly to be considered as middle ear infection. Later, the signs of a middle ear infection change. There is a so-called ear trumpet (Tuba auditiva) which connects the middle ear with the throat.

Often, the swelling in a middle ear inflammation leads to a closure of this ear trumpet. In this case, the mucus that is formed can no longer flow through the ear trumpet into the throat as the mucus would normally do. As a result, more and more mucus and more and more fluid accumulates in the middle ear.

As a result, the pressure becomes greater and greater, and the patient experiences more and more pain and, above all, an ever-increasing feeling of pressure. These are the last signs of middle ear inflammation that should be taken very seriously. If the pressure continues to increase, it is possible that the pressure becomes so strong that it causes the eardrum to rupture.

The eardrum normally separates the middle ear from the outer ear. If the eardrum is now defective, the accumulated fluid and mucus can escape to the outside, and the feeling of pressure and pain immediately subsides. Instead, there is now an outflow, which usually consists of pus, sometimes blood and above all a lot of fluid, from the middle ear to the outside.

The discharge of pus from the middle ear is the last sign of middle ear inflammation and should be avoided at best. In most cases, however, even after a ruptured eardrum, the eardrum heals again and no long-term consequences are to be expected. It is important to note that adults are always easier to diagnose than children. In children, in addition to earaches, unspecific abdominal pain and usually a high fever are common. Therefore, the diagnosis is often more difficult and it should be taken into account whether the child, for example, often has hearing problems or whether he/she often holds his/her ear closed.