In cases of catarrhal otitis media, often bilateral, pain is poor or absent, the child will seem distracted and will tend to ask to repeat words. It is often caused by an infection that, from the throat or nose, invades the Eustachian tube, a small canal that connects the nose to the middle ear, and consequently spreads into the ear. Catarrhal otitis media is frequently found in children, especially within the first 7 years of life, and then disappears by the age of 14.