Otitis Media Questions & Answers

Updated: Mar 19, 2018
  • Author: Muhammad Waseem, MBBS, MS, FAAP, FACEP, FAHA; Chief Editor: Ravindhra G Elluru, MD, PhD  more...
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Questions & Answers

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)?

Why is it critical to distinguish between otitis media with effusion (OME) and acute otitis media (AOM) prior to initiating treatment?

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 causes immune and inflammatory responses that lead to the development of acute otitis media (AOM)?

How does M catarrhalis-induced acute otitis media (AOM) differ from acute otitis media (AOM) caused by other bacteria?

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)?

What are the most common bacterial causes of acute otitis media (AOM) in infants younger than 6 weeks?

Which bacteria may be present in the middle ear of patients with chronic middle ear effusion (MEE) associated with otitis media with effusion (OME)?

Can PCR assay be used to detect bacterial DNA in middle ear effusion (MEE) samples of patients with otitis media with effusion (OME)?

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)?

When does abnormal movement of the tympanic membrane (TM) during pneumatic otoscopy indicate otitis media (OM)?

What is the importance of perforations of tympanic membrane (TM) found during pneumatic otoscopy for 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 are the advantages and disadvantages of performing acoustic reflectometry compared to tympanometry?

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?

How is labyrinthitis treated?

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)?

What is the role of contrast-enhanced CT scanning in the diagnosis of complications of 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)?

At what age do the AAP and AAFP guidelines recommend antibiotics for bilateral or unilateral acute otitis media (AOM)?

What are the alternative medications for acute otitis media (AOM) in children who are allergic to penicillin or beta-lactam?

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 clinical criteria for determining which children will benefit from antimicrobial 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 are the recommendations for antimicrobial selection in the treatment of 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)?

Can steroid therapy be used in patients with exposure to varicella who have not received the varicella vaccine?

What guidelines exist for the management of otitis media with effusion (OME)?

When should surgery be considered in the treatment of acute otitis media (AOM) and 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 the recommendations for the performance of adenoidectomy, tonsillectomy, or both to treat otitis media (OM)?

What surgical interventions should be considered for decreasing the risk of otitis media (OM) in children with cleft palate?

What surgical interventions should be considered for decreasing the risk of otitis media (OM) in children with Down syndrome?

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?

Does administering RSV-IVIG reduce the risk of acute otitis media (AOM) in selected pediatric populations?

Are pneumococcal vaccines effective in reducing the risk of otitis media (OM) in children?

At what age is the influenza vaccine recommended for children and is it effective for decreasing the risk of otitis media (OM)?

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)?

What steps should be taken if effusion persists for more than 12 weeks in children with otitis media?

Guidelines

What are the AAP/AAFP guidelines for the management of acute otitis media (AOM)?

What are the AAO-HNSF, AAP, and AAFP guidelines for the diagnosis and management of otitis media with effusion in children?

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?