Acute Ear Infections

Ear infections are among the most common reasons for children to visit the general practitioner. Having an acute ear infection is very uncomfortable for children, due to signs and symptoms such as ear pain, hearing loss, drainage of mucus from the ear, and loss of balance.

An acute ear infection can develop when there is a negative pressure in the middle ear. This pressure problem is due to dysfunction of the Eustachian tube, a small passageway that connects the ear to the nose. The Eustachian tube is responsible for maintaining an equal pressure between the middle ear and the outside world.  When the Eustachian tube is blocked, the lining of the middle ear starts to change and becomes more easily infected.

Children are more prone to ear infections than adults as their Eustachian tubes are smaller and angled more horizontally. Also, children more often have larger adenoids – pads of tissue at the back of the nose which may contribute to the development of ear infections when enlarged or inflamed. Most children will have had one acute ear infection by the time they are three years old. In most cases, they resolve without further issue.

However, in some cases ear infections become recurrent, which means they happen frequently. They may also start to interfere with your child’s wellbeing. Whether it is your child’s first ear infection or they have a history of many infections over the years, we are here to help.

During your child’s consultation for acute ear infections, examination may include one or more of the following:


Otoscopy-inspection of your child’s outer ears, ear canal and ear drum (tympanic membrane). In case of drainage of mucus from the ear canal, a swab might be taken. 

Tympanometry-a test to determine how your child’s eardrum reacts to varying pressures from outside-a measure for middle ear health and function.

Audiometry (hearing test)- your child will be referred for a hearing test at Nostra Senyora de Meritxell Hospital. Our audiologist will help your child listen to various sounds, and test how well they are able to hear those sounds at different frequencies and intensities. Depending on your child’s age, these sounds will be delivered over hand-held sound stimuli such as a rattle or bell, loudspeakers, or headphones. We will book two appointments: one for the hearing test, and a follow-up appointment at one of our clinics to discuss the results together. If there is drainage of pus from the ear at the time of testing, the hearing test may not be able to be conducted and may have to be postponed until the ear is dry. 

The following treatments may be offered:

Antibiotic treatment-depending on your child’s situation, this may involve antibiotic ear drops only, a course of antibiotics taken by mouth of variable duration, or a combination of both. 

Grommet placement-this procedure involves insertion of a tiny tube into your child’s eardrum. The grommet drains the pus and releases pressure from the middle ear. Once the fluid is drained, the grommet continues to promote a healthy pressure in the middle ear, preventing further ear infections. This is usually done under general anesthesia in children. In older children or teenagers, it may in certain cases be placed under a local anesthetic, depending on the situation and preference. In some cases, grommet placement may be combined with removal of the adenoid as a focus of recurrent ear infections.

More information can be found in our patient information folder.