Children below the age of three are particularly susceptible to acute otitis media due to the size and configuration of the Eustachian tube that connects the middle ear to the back of the nose.

Acute otitis media often occurs after a cold. Viral infection causes swelling of the lining of the nose and Eustachian tube, preventing proper ventilation of the middle ear. At the same time viruses and bacteria can travel up the Eustachian tube to the middle ear, resulting in an infection. Some children who get frequent acute otitis media have glue ear and/or large adenoids.

Otitis externa may occur after swimming, which is why it is sometimes known as Swimmer’s Ear. In early ENT textbooks it was called ‘Singapore Ear’! – testament to the fact that it is common in humid, tropical environments. It can also occur due to cleaning the ear with cotton buds or other instruments as this can scratch the delicate ear canal skin.

Recurring ear infections, especially if they are painless, may also indicate an underlying problem with the eardrum or ear canal, which can lead to more serious consequences if it is not addressed in a timely fashion (see Eardrum perforation/retraction and Cholesteatoma).