tympanic membrane which is typical in a case of acute otitis media
||Ear pain, fever, hearing loss
||Acute otitis media, otitis media with effusion, chronic suppurative otitis media
||Smoke exposure, daycare
benzocaine ear drops
||471 million (2015)
Otitis media is a group of inflammatory diseases of the
 The two main types are acute otitis media (AOM) and otitis media with effusion (OME).
 AOM is an
infection of abrupt onset that usually presents with ear pain. In young children this may result in pulling at the ear, increased crying, and poor sleep. Decreased eating and a
fever may also be present. OME is typically not associated with symptoms.
 Occasionally a feeling of fullness is described. It is defined as the presence of non-infectious fluid in the middle ear for more than three months. Chronic suppurative otitis media (CSOM) is middle ear inflammation of greater than two weeks that results in episodes of discharge from the ear. It may be a complication of acute otitis media. Pain is rarely present.
 All three may be associated with
 The hearing loss in OME, due to its chronic nature, may affect a child's ability to learn.
The cause of AOM is related to childhood
immune function. Either bacteria or viruses may be involved. Risk factors include exposure to smoke, use of
pacifiers, and attending daycare. It occurs more commonly among
Indigenous peoples and those who have
 OME frequently occurs following AOM and may be related to
viral upper respiratory infections, irritants such as smoke, or
 Looking at the eardrum is important for making the correct diagnosis.
 Signs of AOM include bulging or a lack of movement of the
tympanic membrane from a puff of air.
 New discharge not related to
otitis externa also indicates the diagnosis.
A number of measures decrease the risk of otitis media including
influenza vaccination, exclusive
breastfeeding for the first six months of life, and avoiding tobacco smoke.
 The use of
pain medications for AOM is important.
 This may include
benzocaine ear drops, or
 In AOM, antibiotics may speed recovery but may result in side effects.
 Antibiotics are often recommended in those with severe disease or under two years old. In those with less severe disease they may only be recommended in those who do not improve after two or three days.
 The initial antibiotic of choice is typically
amoxicillin. In those with frequent infections
tympanostomy tubes may decrease recurrence.
 In children with otitis media with effusion
antibiotics may increase resolution of symptoms, but may cause diarrhoea, vomiting and skin rash.
Worldwide AOM affect about 11% of people a year (about 325 to 710 million cases).
 Half the cases involve children less than five years of age and it is more common among males.
 Of those affected about 4.8% or 31 million develop chronic suppurative otitis media.
 Before the age of ten OME affects about 80% of children at some point.
 Otitis media resulted in 3,200 deaths in 2015 – down from 4,900 deaths in 1990.