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When your child is diagnosed with an ear infection, be sure to find out what type. The type of infection will dictate the type of treatment that your child should receive.

• Outer Ear Infections (external otitis) Infections of the outer ear are often results from water getting into the ear. This can be very painful, and the ear can be extremely tender to the touch. External otitis is often treated by ear drops or antibiotics.

• Middle Ear Infections (otitis media) The middle ear is the area just behind the eardrum. This is the most common location for ear infection in children. Middle ear infections can be excruciatingly painful. However, the ear is seldom tender to the touch. In a healthy ear, the area behind the eardrum is filled with air. When an infection is present this area becomes inflamed and filled with fluid. Otitis media can be treated with antibiotics or with surgery.

• Middle Ear Fluid (otitis media with effusion)When the middle ear becomes infected, fluid builds up behind the eardrum. Even after the infection has been treated, fluid may remain in the ear for a month or more. Fluid may also develop behind the eardrum as a result of allergies, in reaction to medications, or because of poor ventilation in the ear. The presence of fluid in the ear, if chronic, can cause long term hearing loss and developmental delays in language acquisition in children. Treatment options often include surgery to implant tiny tubes that help the fluid drain out of the ear and increase ventilation.

Chronic ear infections can cause hearing loss and may impede a child's development. Is surgery necessary? It depends. You will need to discuss your child's situation with his pediatrician. Also, consider getting a second or third opinion. Surgery for ear infections has surpassed tonsillectomies as the most common surgery performed on children – and there is a great deal of disagreement among the medical community as to whether surgical intervention is the correct solution.

• One of the main reasons that surgery is becoming the primary treatment option for middle ear infections is that the bacteria that causes middle ear infections is becoming resistant to antibiotic medications. When antibiotics do work, they will often clear up an infection in as little as 48 hours.

• Allergies:There is a growing body of evidence that middle ear infections may be caused by allergies. Consider consulting an allergist to determine if the 'infection' is a result of allergies. Simply removing the allergen may be as effective, and definitely less invasive, than surgery.

In the end, the decision to allow your child to have surgery performed will have to be made between you and your child's doctor. Always remember, no matter how common or 'minor' the surgery, there is always the risk of complications, one of which is death.

There is the fear that children with persistent ear infections may suffer developmental impairments or may have difficulty in acquiring adequate language skills due to hearing impairments. Current research is inconclusive, but there appears to be only minimal delays in language acquisition. Depending upon your child's unique situation, it may be better to treat the infection with medication while an infant, and delay surgery.

There are two main forms of surgery done to correct middle ear infections.

• Myringotomy involves cutting a small slit in the eardrum to allow fluid to drain. This is mostly done to relieve the intense pain that can be caused by fluid build up. It does little to prevent the reoccurrence of the infection.

• Ear Tube Insertion is done in order to allow proper air ventilation and to provide a mechanism for the ear to drain. In children, the Eustachian tubes are not always as fully functional as they should be. The tubes help clear the infection while providing the Eustachian tubes time to become fully functional.

Persistent ear infections may cause developmental delays if it impacts a child's hearing and can lead to permanent hearing loss if left untreated. Treatment, either surgical or medical, is usually called for in the case of ear infections to prevent long-term complications and to minimize pain.