The infection spreads through the Eustachian tube to the middle ear. The risk of contracting an infection is higher if the Eustachian tube is small or does not work efficiently, which is often the case with small children.

Ear infections may also be caused by childhood illnesses, such as measles.

Infections may spread to the bone behind the ear, although this is uncommon.
In rare cases, meningitis or a temporary facial numbing may develop.
The reduction of hearing is usually only temporary, but if cases of inflammation are recurrent it may become chronic and result in delayed language development.

A middle ear infection can usually be treated by your GP. However, if there is persistent hearing loss a specialist should be consulted.