Acute Otitis Media

Question 1

What is Acute Otitis Media also known as?

Answer 1

Middle ear inflammation

Question 2

Acute Otitis Media pathology

Answer 2

When the middle ear/eustachian tube becomes inflamed and traps fluid in the middle ear. Fluid becomes infected

Question 3

Acute Otitis Media peak incidence

Answer 3

3-18 months

Question 4

Acute Otitis Media causative organisms

Answer 4

Haemophilus influenza (most common bact)
Strept pneumoniae
Moraxella Catarrhalis 
50% = viral 
60% improve without antibiotics

Question 5

Acute Otitis Media Complications

Answer 5

Extracranial FALOC - facial nerve palsy, 
- acute mastoiditis 
- labyrinthitis
- ossicular damage
- chronic perforation
Intracranial FAMS
- ferbile convulsion
- abscess (brain)
- meningitis
- subdural empyema

Question 6

Acute Otitis Media Presentation

Answer 6

Rapid onset of ear pain
Fever
Irritability 
Anorexia 
Vomiting
Often after a viral URTI
Other Symptoms: 
ear discharge, systemic upset, sleep disturbance, short history . 
In a child they may be unwell, screaming and rubbing their ears.

Question 7

Acute Otitis Media Investigations

Answer 7

Otoscopy: bulging, opacified tympanic membrane with decreased mobillity
Others: 
Tympanometry 
Refelctometry
Hearing test

Question 8

Acute Otitis Media Treatment

Answer 8

Analgesia and home care - first line =
- ear drops
- warm moist cloth
Antibiotics if worsening =
- Amoxicillin - first line
- Coamoxiclav - second line
5-7 days
If not - 
Erythromycin or Clarithromycin
If recurrent =
Grommet Insertion
Adenoidectomy