Prognosis
Ear infections in infants less than 3 months old may indicate more serious infections, such as meningitis. But a reassuring 2002 study reported that only 4% of infants with an ear infection had a bacterial infection. Still, any sign of infection in a baby requires prompt medical attention.
Hearing Loss and Its Consequences
Evidence strongly suggests that severe cases of recurrent acute otitis media and persistent otitis media with effusion (OME) impair hearing. The effect of long-term hearing problems may have the following effects:
- Learning Delays. Hearing loss in children slows down language development and reading skills. Children with even mild hearing loss may miss spoken words and have trouble making sense out of a conversation or a lesson in school. It is not clear, however, even after years of research, if OME and related hearing loss have any significant long-term effects on learning. Some research suggests that the effects may last into the teens. Other studies, however, indicate that any effect on learning is temporary and that children catch up later on. Further evidence has found that lower learning scores reported in children with OME may be due to the fact that such children tend to be in lower socioeconomic groups.
- Behavioral and Social Problems. Children with impaired hearing may appear to be distracted, inattentive, and unintelligent. Some have even been inaccurately diagnosed as having attention deficit hyperactivity disorder. As with learning, studies have also been mixed on the significance of long-term effects of OME on behavior.
- Speech Problems. A few studies have found speech problems in some young children with OME.
Physical and Structural Injuries in the Face and Ears
Serious complications or permanent physical injuries from ear infections are very uncommon, but may include:
- Structural damage. Certain children with severe or recurrent otitis media may be at risk for structural damage in the ear.
- Cholesteatomas. Cysts in the ear called cholesteatomas are an uncommon complication of recurrent or severe ear infections.
- Calcifications. In rare cases, even after a mild infection, some children develop calcification and hardening in the middle and, occasionally, in the inner ear. This may be due to immune abnormalities.
Mastoiditis
Before the introduction of antibiotics, mastoiditis (an infection in the bones located in the skull), was a serious, albeit rare, complication of otitis media. This condition is difficult to treat and requires intravenous antibiotics and drainage procedures. Surgery may be required.
If pain and fever persist in spite of antibiotic treatment of otitis media, the doctor should check for mastoiditis. Most cases of mastoiditis are generally not associated with ear infections.
Other Possible Complications
Impaired Balance. Some studies have indicated that children with chronic OME have problems with motor development and balance.
Facial Paralysis. Very rarely, a child may develop facial paralysis, which is temporary and relieved by drainage surgery.
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