1. Acute Otitis Media

2. Pathology
• Inflammation of the middle ear cleft mucosa and
associated ET tube
• Acute < 3 weeks
• Originate as an infection – bacterial, viral
• Bacteria  Streptococcus pneumoniae,
Haemophilus influenzae, Morexella catarrhalis ;
infants ~20% Gm –ve enterobacteria
• Viruses  isolated in 4% RSV, Influenza
• Causes a blocked ET  middle ear fluid

3. Children
• Horizontal ET
• Smaller Lumen
• RTI

4. Symptoms
• Ear ache
• Discharge
• Hearing Loss
• Fever
• Irritability

5. Signs
• General Fever
Toxic
• Local Red TM
Perforation
Free Field tests  HL
WT 
RT (-) ve
VII / Nystagmus (complications)
Mastoiditis

6. Diagnosis
• Clinical
• Culture + ABST
• PTA / Tympanogram

7. Treatment
• Antibiotics - Amoxycillin, Co–Amoxyclav
• Nasal Decongestants
• Steam
• Anti-pyretic
• Analgesics
• Anti-histamines

8. Complications
Intratemporal
• CHL,SNHL
• Perforation
• Retraction pocket
• Cholestetoma
• Tympanosclerosis
• Ossicular chain fixation or disconiniuity
• Mastoiditis
• Petrositis / Gradenigo
• Labyrinthitis
• PLF
• VII
• Cholesterol granuloma

9. Complications
Intracranial
• Extra-dural Abscess
• Meningitis
• Sub-dural empyema
• Focal otitic encephalitis
• Lateral Sinus thrombosis
• Otitic hydrocephalus
• Intracerebral Abscess