Otitis media acuta

Abstract

Acute otitis media (AOM) is a common, acute inflammation of the middle ear mucosa especially in toddlers. The etiology is caused by viruses such as Rhino-, RS-, Adeno-, Parainfluenza- und Influenza-viruses in most of the cases (80%). A bacterial superinfection due to Streptococcus pneumonia, Haemophilus influenza, Moraxella catarrhalis, group-A streptococci and Staphylococcus aureus can be observed in about 20% of all cases. Main symptoms are earache, fever, otorrhea, hearing loss and poor feeding. The diagnosis of AOM is established by otoscopy revealing an undifferentiated, red and bulged tympanic membrane. After spontaneous perforation of the ear drum ear discharge may develop. Therapy is mainly focused on control of symptoms with analgetics like paracetamol, ibuprofen etc. and can be a “watch and wait strategy”. Antibiotic treatment is recommended in very small children with a serious AOM, in cases with otorrhea and in bilateral AOM or patients with risk factors. Prognosis of AOA usually is good, however recurrent AOM may develop. Several complications of AOA including mastoiditis, facial nerve paralysis, sigmoid sinus thrombosis, meningitis, brain abscess and labyrinthitis can occur, which afford a consequent management by an ENT-specialist.