My-ENT

Condition

Clinical assessment for ear infection symptoms at My-ENT Sydney.

Ear infections

Clinical term: Otitis externa and otitis media

Ear infections can affect the outer ear canal or the middle ear space behind the eardrum. Symptoms may include pain, pressure, reduced hearing, or discharge. While many infections settle with GP care, repeated episodes or persistent symptoms often benefit from ENT assessment.

Symptoms

What patients often notice

  • Ear pain, tenderness, or pressure that can worsen when lying down.
  • Blocked hearing or muffled sound on one or both sides.
  • Ear discharge, including fluid or pus, in some infections.
  • Fever or feeling generally unwell, particularly with acute middle-ear infection.
  • Irritability, sleep disturbance, or pulling at the ear in children.

Causes

Why this can happen

A cold or viral upper respiratory infection causing swelling that blocks the tube connecting the nose to the middle ear.

The Eustachian tube in young children being shorter and flatter than in adults, making it easier for bacteria and viruses to reach the middle ear - this explains why ear infections are far more common in children under five.

Enlarged adenoids blocking the drainage pathway and harbouring bacteria that contribute to recurrent infections.

Glue ear - thick fluid accumulating in the middle ear without acute infection - often following repeated ear infections or persistent Eustachian tube dysfunction.

Exposure to cigarette smoke, which is a well-established risk factor for both acute and recurrent ear infections in children.

Rosenfeld RM et al. Clinical Practice Guideline: Otitis Media with Effusion. Otolaryngol Head Neck Surg. 2016;154(1 Suppl):S1-S41. NICE guideline NG91: Otitis media (acute). 2018.

When to seek help

When to arrange review

Arrange specialist review if infections are recurring, hearing remains reduced after treatment, discharge persists, or symptoms are affecting school, sleep, or day-to-day function. Same-day medical review is important for severe pain, high fever, swelling behind the ear, or sudden worsening.

Request an appointment

Treatment

Treatment overview

Treatment depends on where the infection is and how often episodes occur. Management can include targeted ear drops, oral medicines, pain control, hearing review, and investigation of contributing nasal or middle-ear factors. For selected patients with recurrent middle-ear disease, procedures such as grommets may be discussed.

Choosing your surgeon

Choosing your surgeon

Choosing the right specialist takes thought. Fellowship training, experience with the relevant condition, and contribution to teaching and research are all meaningful indicators. A public appointment at a tertiary hospital is another recognised marker of professional standing. Online reviews can be helpful, but they don't tell the whole story.