Overview
What is otitis media (OM) and what are its subtypes?
What presentation and symptoms indicate acute otitis media (AOM)?
What symptoms indicate otitis media with effusion (OME)?
What is chronic suppurative otitis media (OM)?
What is adhesive otitis media (OM)?
Which exam technique is used to diagnose otitis media with effusion (OME)?
What is the treatment for acute otitis media (AOM)?
What are the treatment guidelines for acute otitis media (AOM) in children?
How prevalent is otitis media (OM)?
How is otitis media (OM) classified?
What are the symptoms of acute otitis media (AOM)?
What is otitis media with effusion (OME)?
How is chronic suppurative otitis media (OM) defined?
What is the pathophysiology of otitis media (OM)?
What is the pathophysiology of acute otitis media (AOM) in children?
What factors contribute to the etiology of otitis media (OM)?
How is the immune system involved in the etiology of otitis media (OM)?
Which genes have been linked to otitis media (OM)?
What is the role of mucins in otitis media with effusion (OME)?
What anatomic abnormalities increase the risk for otitis media (OM)?
What physiologic dysfunctions increase the risk for otitis media (OM)?
Is vitamin A deficiency a risk factor for acute otitis media (AOM)?
Does obesity increase the risk for otitis media (OM)?
What are the most common bacterial causes of acute otitis media (AOM)?
Which pathogens are most frequently isolated organisms in chronic suppurative otitis media (OM)?
What is the role of Helicobacter pylori (H pylori) in children with otitis media (OM)?
What is the clinical role of Alloiococcus otitidis in otitis media (OM)?
What is the role of respiratory viruses in acute otitis media (AOM)?
Do allergies have an etiologic role in otitis media (OM)?
Does breastfeeding protect infants against otitis media (OM)?
Does passive smoke exposure increase the risk of otitis media (OM) in children?
What affect do daycare centers have on a child's risk of developing otitis media (OM)?
How does socioeconomic status affect the risk of otitis media (OM) in children?
What is the prevalence of otitis media (OM) in the US?
What is the global incidence of otitis media (OM)?
What is the prevalence of otitis media (OM) among different age groups?
Is otitis media (OM) more common in males or females?
What are the differences in the prevalence of otitis media (OM) among races?
What is the risk of mortality associated with otitis media (OM)?
What are the complications of otitis media (OM)?
What is the prognosis of otitis media (OM)?
Does otitis media (OM) affect cognitive and educations outcomes?
What topics should be included when educating patients and their families about otitis media (OM)?
What topics should be included when educating health care providers about otitis media (OM)?
Presentation
What head and neck symptoms raise suspicion of acute otitis media (AOM)?
What general symptoms are frequently seen in children with acute otitis media (AOM)?
What are GI tract symptoms of acute otitis media (AOM)?
What medical history and symptoms suggest otitis media with effusion (OME)?
Which factors should be considered prior to the treatment of otitis media (OM)?
What are environmental risk factors of otitis media (OM)?
What is the standard exam technique for suspected otitis media (OM)?
How often is a proper pneumatic otoscopy technique performed when diagnosing otitis media (OM)?
What adjunctive testing is helpful in evaluating middle ear effusion (MEE)?
What is the purpose of head and neck exam in otitis media (OM)?
How is pneumatic otoscopy for otitis media (OM) performed?
What color of the tympanic membrane (TM) indicates otitis media (OM)?
What position of tympanic membrane (TM) indicates otitis media (OM)?
What is the purpose of adjunctive screening techniques for otitis media (OM)?
What are the recommendations for screening tympanometry in children?
How is acoustic reflectometry helpful in the diagnosis of otitis media (OM)?
What is the breakpoint for detecting middle ear effusion (MEE) during acoustic reflectometry?
What are the forms of mastoid infections and how are they treated?
What causes acute coalescent mastoiditis and how is its diagnosis confirmed?
When does chronic mastoiditis occur and how is it diagnosed?
What are the contributing factors to the development of cholesteatomas?
How are cholesteatomas diagnosed?
How are cholesteatomas treated?
What are the acute symptoms of suppurative labyrinthitis?
How is labyrinthitis diagnosed?
What causes facial paralysis in patients with otitis media?
What is the treatment for facial paralysis due to otitis media (OM)?
How is meningitis caused by otitis media (OM) diagnosed and treated?
How do epidural abscesses secondary to otitis media (OM) form?
How are epidural abscesses secondary to otitis media (OM) diagnosed and treated?
How does otitis media (OM) cause lateral sinus thrombophlebitis?
How is otitis media (OM) lateral sinus thrombophlebitis diagnosed and treated?
What causes otitis media (OM)–associated brain abscesses?
What are signs and symptoms of otitis media (OM)–associated brain abscesses?
How are otitis media (OM) brain abscesses diagnosed and treated?
DDX
What are the differential diagnoses for Otitis Media?
Workup
When is a full sepsis workup indicated in infants with acute otitis media (AOM)?
When are imaging studies indicated in patients with otitis media (OM)?
When is MRI helpful in the diagnosis of otitis media (OM)?
What is the role of tympanocentesis in otitis media (OM) diagnosis?
When is early tympanocentesis indicated in the evaluation of acute otitis media (AOM)?
When are tympanometry and acoustic reflectometry helpful in the diagnosis of otitis media (OM)?
Treatment
Why is medical management for otitis media (OM) controversial?
What are the CDC recommendations for first-line treatment of acute otitis media (AOM)?
What are the CDC recommendations for second-line treatment of otitis media (OM)?
Why are only 3 of 16 FDA-approved antimicrobials for otitis media (OM) recommended by the CDC?
What are the primary determinants of treatment compliance in children with acute otitis media (AOM)?
Is trimethoprim-sulfamethoxazole effective in treating acute otitis media (AOM)?
Which macrolides are preferred in the treatment of acute otitis media (AOM)?
What is the common disease progression of otitis media with effusion (OME)?
Does chronic otitis media with effusion (OME) cause hearing loss?
What is the most effective treatment for otitis media (OME)?
When should surgery be considered for otitis media with effusion (OME)?
What is the recommended duration of antimicrobial therapy for otitis media with effusion (OME)?
What is known regarding the effectiveness of steroid therapy for otitis media with effusion (OME)?
What is the steroid therapy regimen for otitis media with effusion (OME)?
What guidelines exist for the management of otitis media with effusion (OME)?
What are the indications for tympanocentesis in otitis media (OM)?
What are the guidelines for the use of tympanostomy tubes (TT) in children with otitis media (OM)?
What are medical and surgical options for otitis media (OM) prevention?
What are environmental risk factors for otitis media (OM) in children?
How does daycare attendance increase the risk of otitis media (OM) in children?
How does second-hand passive smoke exposure increase the risk of otitis media (OM) in children?
How does pacifier use increase the risk of otitis media (OM) in children?
How does breastfeeding reduce the risk of otitis media (OM) in infants?
Are pneumococcal vaccines effective in reducing the risk of otitis media (OM) in children?
Is antibiotic prophylaxis effective in preventing recurrent acute otitis media (AOM)?
When should children with otitis media (OM) be referred to specialists?
When is inpatient care indicated for otitis media (OM)?
How should children with recurrent cases of acute otitis media (AOM) be monitored?
How frequent should follow-up visits occur in cases of otitis media (OM)?
Guidelines
What are the AAP/AAFP guidelines for the management of acute otitis media (AOM)?
Medications
Are there FDA-approved antibiotics for the treatment of otitis media (OM)?
Which medications in the drug class Antimicrobial agents are used in the treatment of Otitis Media?
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Diagram of the normal tympanic membrane anatomy.
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Healthy tympanic membrane.
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Acute otitis media with purulent effusion behind a bulging tympanic membrane.
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Chronic otitis media with a retraction pocket of the pars flaccida.
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Cholesteatoma of the pars flaccida.
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Central/pars tensa tympanic membrane perforation with a healthy middle ear membrane.
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Central/pars tensa tympanic membrane perforation with a tympanostomy tube in place.
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Various tympanostomy tube styles and sizes.
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Initial presentation of a young girl with chronic right ear pain and multiple untreated middle ear infections.
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Acute coalescent mastoiditis with a Bezold abscess in a young girl who presented with chronic right ear pain and multiple untreated middle ear infections.
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A young girl who presented with chronic right ear pain and multiple untreated middle ear infections on the operating table for mastoidectomy and drainage of Bezold abscess.
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Aspirating pus from the Bezold abscess for Gram staining, culturing, and sensitivity testing in a young girl who presented with chronic right ear pain and multiple untreated middle ear infections.
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Surgical incision to aspirate pus in a young girl who presented with chronic right ear pain and multiple untreated middle ear infections.
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Freer elevator demonstrating extension of an abscess cavity from the mastoid into the neck in a young girl who presented with chronic right ear pain and multiple untreated middle ear infections.
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Incision is closed and a drain is placed in the abscess cavity in a young girl who presented with chronic right ear pain and multiple untreated middle ear infections.
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Postoperative bandage in a young girl who presented with chronic right ear pain and multiple untreated middle ear infections.
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The wound now appears clean and dry on postoperative day 4. This young girl initially presented with chronic right ear pain and multiple untreated middle ear infections.
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Postoperative day 4: Mom is smiling. This young girl initially presented with chronic right ear pain and multiple untreated middle ear infections.