This topic provides information about otitis media.
What is otitis media?
Otitis media is an inflammation or infection that occurs in the middle ear, the air-filled space between the eardrum and the cochlea (inner ear). “otitis” means inflammation of the ear and “media” means in the middle ear space.
There are three types of otitis media:
- Acute otitis media (AOM) is a bacterial or viral infection of the middle ear, with an accumulation of fluid, or “pus”. It usually comes on rapidly and quickly resolves with treatment.
- Chronic otitis media (COM) is a persistent inflammation and/or bacterial or viral infection of the middle ear that lasts over one month or reoccurs 3 times in 6 months or 4 times in one year.
- Otitis media with effusion (OME) is fluid in the middle ear with no signs of infection. Symptoms will include pressure in the ear without pain that is associated with acute otitis media.
What causes otitis media?
Otitis media usually develops in conjunction with another illness such as a cold, upper respiratory infection, or flu. These illnesses cause congestion and swelling of the nasal passages and throat and can cause eustachian tube dysfunction.
The eustachian tubes are small tubes that connect the middle ear to the back of the throat and nose. They are responsible for regulating the air pressure in the middle ear and draining normal secretions out of the middle ear. When they are not functioning properly, fluid can accumulate in the middle ear space. The fluid can then become infected with a bacterial or viral infection.
You have a greater chance of getting otitis media as a child who is exposed to children’s colds, such as in a daycare center. There is also a higher risk developing otitis media if bottle feeding or exposed to second-hand cigarette smoke.
Otitis media is more common in children because their eustachian tubes are smaller and lay more horizontal, making them more difficult to drain.
What are the symptoms?
Symptoms of otitis media can include:
- Pain in the ear (otalgia)
- Fullness of the ear
- Temporary conductive hearing loss
How is otitis media diagnosed?
Identification of otitis media can be done by a physician by using an otoscope to look in the ear. The fluid of the middle ear may be visible, as well as a bulging of the tympanic membrane (eardrum). Pneumatic otoscopy may also be used for diagnosis. This delivers a small puff of air into the ear. If the eardrum does not move in response, it is likely that there is fluid in the middle ear.
Additional tests can be used to confirm the diagnosis of otitis media. These can include:
Tympanometry testing. Measures the movement of the eadrum by changing the pressure on the eardrum. No movement or limited movement of the eardrum can confirm presence of fluid in the middle ear.
Audiometric testing. Your physician may also refer you to see an audiologist who will perform a hearing exam to determine if and how the otitis media is affecting the hearing. If fluid is present in the middle ear, the patient will likely have a conductive hearing loss.
How is it treated?
The first step in treating otitis media is with the use of antibiotics.
With chronic otitis media, the patient should be seen by an ENT (otolaryngologist) to determine if a pressure equalization tube (PE Tube/tympanostomy tube) is necessary.This small tube is inserted into the eardrum in an outpatient procedure to help drain the fluid from the middle ear and act as a “seconday” eustachian tube to help equalize the pressure.