Infection of the mucosa lining the middle ear and the cavities anatomically connected to the middle ear (mastoid cells and Eustachian tube) is called otitis media.⠀ ⠀ Otitis media occurs when bacteria or viruses in the nose or throat cavity reach the middle ear through the eustachian tube. Sometimes, due to allergies or large adenoids, edema in the eustachian canal and fluid accumulation in the middle ear may occur. ⠀ ⠀ Classification of middle ear infections: ⠀ ⠀ It is defined as acute for the first 3 weeks, subacute for 3 weeks to 3 months, and chronic for more than 3 months.⠀ ⠀ Myringitis: It is inflammation of the eardrum with or without otitis media. ⠀ ⠀ Acute otitis media: It is a short-term otitis media characterized by sudden onset and pain. ⠀ ⠀ Middle ear infection with effusion: It is the accumulation of fluid (effusion) behind the intact eardrum without sudden and severe symptoms. It describes a long-term middle ear problem. ⠀ Chronic otitis media: Chronic otitis media is chronic inflammation of the mucosa in the middle ear cavity, eustachian tube and mastoid cell spaces associated with the middle ear. ⠀ ⠀ Common signs and symptoms in adults include:⠀ ⠀ • Earache⠀ • Ear discharge⠀ • Decreased hearing⠀ ⠀ Common signs and symptoms in children include:⠀ ⠀ • Earache⠀ • Ear pulling ⠀ • Sleep problem⠀ • Increased crying⠀ • Trouble hearing or responding to sounds⠀ • Loss of balance⠀ • High fever⠀ • Ear discharge⠀ • Headache⠀ • Loss of appetite⠀ ⠀ Recurrent ear infections or fluid in the middle ear can cause more significant hearing loss. If there is damage to the eardrum or other middle ear structures, permanent hearing loss may occur.