Otitis Media

Otitis Media is an infection of the middle ear. There different forms of otitis media.

Otitis Media 1

Acute otitis media occurs with a rapid onset of pain in the ear sometimes fever. It is often accompanied by an upper respiratory infection (common cold) and occurs most frequently in children. It is caused by a bacterial infection of the middle ear.

Otitis Media 2

Otitis media with effusion is fluid accumulation within the middle ear. This may represent a persistence of fluid in the middle ear after an acute otitis media has resolved. It also can result from air pressure trauma to the middle ear, and may occur after an air flight or a scuba dive. Otitis media with effusion is a common problem in children, and is much less common in adults.

Otitis Media 3

Chronic otitis media represents a chronic recurrent infection of the middle ear. In this form of infection the eardrum is perforated and the ear recurrently drains when infected.

What are the treatments for otitis media?

Acute otitis media is best treated with a course of antibiotics. This usually results in complete resolution of the symptoms. Pain medication is sometimes needed during the first 24 to 48 hours.

In a child, the treatment of otitis media with effusion is somewhat controversial. Potential treatments include watchful waiting for the fluid to resolve, a prolonged course of antibiotics or placement of a tube in the eardrum to allow for drainage of the fluid and to allow for air to enter the middle ear. Currently, the National Institute of Health has published guidelines for the treatment of otitis media with effusion. Parents should make sure that their physicians follow the current NIH guidelines.

In the adult, otitis media with effusion is typically a temporary process that can be treated with decongestants, antibiotics, and sometimes oral steroids such as prednisone. Occasionally this fluid will not resolve and placement of a temporary tube in the eardrum to drain the fluid and allow for air to enter the middle ear is necessary.

Chronic otitis media is treated with a combination of eardrops and, at times, antibiotics by mouth. Ultimately, surgery may be required to eradicate the infection and close the hole in the eardrum.

Are there factors that predispose an individual to otitis media?

Otitis Media 4

The main predisposing factor for all forms of otitis media appears to be poor Eustachian Tube function. Failure of the Eustachian Tube to allow for air to enter into the middle ear impairs normal middle ear function and creates an environment in which bacteria can grow. This is a more common problem in children but may persist in some adults. Other factors, such as the way the middle ear combats infection, may also play a role.