Otitis
Media
Otitis Media is the most common medical condition for which
children require medical treatment in the United States. It is also a common
problem in adults although to a much lesser degree.
Acute Otitis Media. This is an acute bacterial
infection involving the middle ear space. It typically presents with severe ear
pain, fever and hearing loss. It often responds well to antibiotics unless the
pathogens involved are resistant to multiple antibiotics. Occasionally, the
eardrum will perforate as a result of infection and this manifests as yellow
drainage from the ear canal. Patients who suffer from frequent episodes of
Otitis Media are candidates for bilateral ear tube placement which has been
proven to dramatically decrease the frequency of infections. In addition, when
infection does occur after placement of ear tubes, it can more easily be treated
with placement of antibiotic drops directly in the ear canal. Ear tubes also
make such infections, when they do occur, painless.
Chronic Otitis Media. This condition is more
common in adults, and is usually associated with a chronic perforation of the
eardrum. It is thought to result from chronic low-grade infection in the middle
ear space as well as the mastoid bone behind the ear. Poor ventilation of the
middle ear space due to Eustachian tube dysfunction also plays a role. Although
antibiotics may provide temporary improvement, most patients will ultimately
require surgery such as
tympanomastoidectomy.
Serous Otitis Media. This is usually a sequel
of an episode of Acute Otitis Media. After resolution of the acute bacterial
infection there can be retention of fluid in the middle ear space which can
present with painless ear fullness and hearing loss. It is important to
diagnose this problem in young children since it may result in hearing loss that
may go unrecognized for long periods of time and can result in speech delay.
Some patients require placement of ear tubes if this condition persists.
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