Otitis Media

Otitis Media is the most common medical condition for which children require medical treatment in the United States. It is also a common problem in adults although to a much lesser degree.

Acute Otitis Media. This is an acute bacterial infection involving the middle ear space. It typically presents with severe ear pain, fever and hearing loss. It often responds well to antibiotics unless the pathogens involved are resistant to multiple antibiotics. Occasionally, the eardrum will perforate as a result of infection and this manifests as yellow drainage from the ear canal. Patients who suffer from frequent episodes of Otitis Media are candidates for bilateral ear tube placement which has been proven to dramatically decrease the frequency of infections. In addition, when infection does occur after placement of ear tubes, it can more easily be treated with placement of antibiotic drops directly in the ear canal. Ear tubes also make such infections, when they do occur, painless.

Chronic Otitis Media. This condition is more common in adults, and is usually associated with a chronic perforation of the eardrum. It is thought to result from chronic low-grade infection in the middle ear space as well as the mastoid bone behind the ear. Poor ventilation of the middle ear space due to Eustachian tube dysfunction also plays a role. Although antibiotics may provide temporary improvement, most patients will ultimately require surgery such as tympanomastoidectomy.

Serous Otitis Media. This is usually a sequel of an episode of Acute Otitis Media. After resolution of the acute bacterial infection there can be retention of fluid in the middle ear space which can present with painless ear fullness and hearing loss. It is important to diagnose this problem in young children since it may result in hearing loss that may go unrecognized for long periods of time and can result in speech delay. Some patients require placement of ear tubes if this condition persists.

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