2) Congestion and Swelling of the Adenoids

Congestion and Swelling of the Adenoids are common signs associated with upper respiratory tract infection. Adenoid is a part of the lymphatic system which traps germs and pathogens and prevents their growth, in case of infection it may show congestion.
People may wonder what this has to do with a middle ear infection. The adenoid is placed beside the opening of the eustachian tube, so if it gets enlarged it may obstruct the eustachian tube, prevent middle ear drainage and increase the risk of otitis media.