The adenoid is located at the mouth of the Eustachian tube and any infection or swelling in the adenoid may affect the tube. Before antibiotics and tympanostomy tubes were available, removal of the adenoid was the only surgical treatment for otitis media. Recent studies have shown that removal of the adenoid is still a useful treatment for children with otitis media. During infancy, pain and fever are common signs of acute otitis media. Older children often have chronic otitis media with effusion in which fluid is present in the middle ear but without pain or fever.
Many children develop otitis media with effusion after acute otitis media.
Others have recurrent acute otitis media with the ears clearing between episodes. Treatment of acute otitis media is primarily with antibiotics. Decongestants are often prescribed for nasal congestion, which is often a coexisting problem. However, decongestants do not, in and of themselves, help alleviate the ear infection. For children who have multiple episodes, prevention is the next step.