Ear Infections

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U.S. News & World Report Best Hospitals for ear, nose, and throat care

Nationally Ranked in Ear, Nose, and Throat Care

UT Southwestern Medical Center is recognized by U.S. News & World Report as one of the nation's top hospitals for otolaryngology, also known as ear, nose, and throat care.




At UT Southwestern Medical Center, our ear, nose, and throat (ENT) doctors are experienced at diagnosing and treating ear infections, which most commonly occur in children. When patients experience chronic ear disease from recurrent infections, we provide the most advanced treatment options, including minimally invasive surgery.

Experts in Diagnosing and Treating Ear Infections

An ear infection occurs when the Eustachian tubes that connect the throat to the middle ear do not function properly. This leads to negative pressure in the middle ear spaces and causes fluid to build up in the middle ear, which can promote the growth of viruses or bacteria.

Ear infections are more common in children than in adults. Recurring ear infections are associated with chronic ear disease, which can cause hearing loss or other serious complications.

At UT Southwestern, our ENT physicians are skilled at treating ear infections in patients of all ages. As one of the nation’s leading clinical and research centers for ENT conditions, we provide the most advanced treatments and resources in a patient-centered environment.

A ruptured eardrum can result from ear infections, and our ear surgeons are leading the way in minimally invasive surgical techniques for eardrum repairs.

Causes of Ear Infections

Children are more prone to ear infections because their Eustachian tubes are shorter, more horizontal, and more likely to collapse or just not function properly, failing to open and ventilate the middle ear space.

Eustachian tubes can become blocked from:

  • Acid reflux
  • Allergies
  • Changes in air pressure
  • Colds
  • Excess mucus
  • Sinus infections
  • Smoking (or exposure to secondhand smoke)
  • Swollen adenoids (a patch of tissue located behind the nose that clears away bacteria and viruses)

Symptoms of Ear Infections

In children, common ear infection symptoms include:

  • Difficulty sleeping
  • Earache
  • Fever
  • Fluid draining from the ear
  • Headache
  • Loss of appetite
  • Loss of balance
  • Pulling at an ear
  • Trouble hearing

In adults, symptoms include:

  • Earache
  • Fluid draining from the ear
  • Nausea
  • Trouble hearing

Diagnosing Ear Infections

To diagnose an ear infection, we begin with a thorough evaluation, which includes a:

  • Discussion of medical history
  • Discussion of symptoms and risk factors
  • Physical exam
  • Hearing test (audiometry exam)

Using an otoscope, an instrument that has a flashlight and magnifying lens, we’ll examine the patient’s ears, looking for signs such as redness, fluid inside the middle ear or draining from it, or a perforation (hole or tear) in the eardrum.

We may use a pneumatic otoscope, which uses a puff of air to evaluate eardrum movement. If the eardrum doesn’t move, it could mean there’s fluid behind it.

If a diagnosis isn’t clear and we need more information, we may order a:

  • Computed tomography (CT) scan to create detailed images of the ear and surrounding structures, which will help us determine if the infection has spread
  • Tympanometry, an acoustic test that measures eardrum and middle ear function

Patients who have chronic ear infections may be referred to a hearing specialist, development therapist, or speech therapist for tests that measure hearing, language, or speech function.

Treatment of Ear Infections

Most minor ear infections resolve on their own. Patients can manage symptoms by:

  • Taking acetaminophen, ibuprofen, or another over-the-counter pain medication
  • Applying a warm cloth to the ear
  • Using anesthetic ear drops (should not be used if there’s a perforation in the eardrum)

If the infection doesn’t clear up after a period of observation, we may prescribe antibiotics.

If there are recurrent ear infections (four episodes in six months or six episodes in 12 months) or fluid in the middle ear space that persists for three months or more, particularly when associated with a hearing loss and/or speech delay, surgery to place tubes in the eardrum might be recommended. In most cases, these tubes are temporary and will fall out of the eardrum on their own.

For chronic ear disease, we may recommend more complex ear surgery. This may involve tympanoplasty, a type of surgery that repairs the eardrum and hearing bones. The surgery may be done with a mastoidectomy, a surgery in which part of the bone behind the ear canal and middle ear is opened with a surgical drill.