As explained earlier, the Eustachian tube plays a crucial role in regulating the pressure inside the middle ear. Once the tube stops working, the abnormal pressure inside the middle ear causes fluid to accumulate there. This stagnant fluid, which is rich in protein and sugar, is an ideal growth medium for bacteria. If the pressure does not normalize quickly, bacteria flourish in this fluid, starting an infection in the middle ear. When doctors use the term “ear infection,” they are generally referring to a middle ear infection.

In short, whenever the Eustachian tube does not function normally, the chance of getting an ear infection increases. There are several situations in which the functionality of the Eustachian tube may be impaired.

The Common Cold

Among all the possible risk factors for triggering an ear infection, catching a cold is by far the most common. When your child has a cold, his nose and throat are usually stuffed with mucus. Since the Eustachian tube connects the middle ear and the throat, it is easy for the excessive secretion to compromise the function of the tube. Once the Eustachian tube is blocked, it may be just a matter of time before your child comes down with an ear infection, especially if he is prone to getting them.

Consequently, the best way to prevent an ear infection is to avoid catching a cold. The most effective strategy for avoiding a cold is frequent hand washing.

Nasal Allergy

Someone with chronic and recurrent ear infections also often suffers from nasal allergy. Similar to having a cold, a child with nasal allergy has constant excessive secretion in the nose and throat. This abundance of mucus blocks the Eustachian tube and increases the child's chance of getting an ear infection.

Unfortunately, these children frequently return to the doctor's office for ear infections over and over again, and they take antibiotics repeatedly for these episodes. In some cases they are never treated for the real cause of these recurrent ear infections. It is important to remember that as long as a child's nasal allergy is not controlled, she is at high risk for getting more ear infections. The most important thing is for the doctors treating these children to recognize the presence of their allergy and treat the allergy with appropriate medication. Otherwise, the children are doomed to suffer this terrible problem of constant ear pain. Some of them might even receive surgery unnecessarily because of their multiple infections. (The role of surgery in treating ear infection is addressed on page 87).

Unusual Anatomy

Differences in the shape and configuration of the Eustachian tube can cause some children to suffer from ear infections more frequently than others, as stated previously. Other anatomical structures, including the size and position of the tongue and the overall shape of the head, can also indirectly influence the functionality of the Eustachian tube.

For example, children with Down syndrome tend to have larger tongues, which is more likely to obstruct the opening of the Eustachian tube. Children with smaller heads as a result of other medical conditions have more ear infections because their tubes are smaller as well. The bottom line is that a working Eustachian tube is paramount in preventing ear infections.