Otitis Media

Question 1

Otitis Media:

2 Main forms?

Answer 1

Otitis media with effusion (OME) or without effusion

Can be infectious (with symptoms) or non infectious (symptom free)

Question 2

Otitis Media:

When to treat with Antibiotics?

Answer 2

1) < 6 months of age
2) < 2years AND bilateral AOM
3) systemically unwell
4) High complication risk (immunosuppressed)
5) ATSI
6) not resolved in 3 days
7) chronic suppurative otitis media (not acute)

Question 3

Otitis Media:

Risk factors for recurrent infections?

Answer 3

• group child care
• allergic rhinitis
• adenoid disease
• structural anomalies
• exposure to smoke (eg cigarettes, wood fires)
• socioeconomic disadvantage (eg crowded housing)

Question 4

Otitis Media:

most common pathogens?

Answer 4

Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis

Question 5

Otitis Media:

Time for effusion to resolve?

Answer 5

90% in 3 months after resolution of AOM

Question 6

Otitis Media:

How to manage OME?

Answer 6

< 3 months duration
-monitor
-referral to ENT if associated with speech delay or learning problems, or if there is structural damage to the tympanic membrane (eg significant retraction, cholesteatoma)
> 3 months (glue ear)
-audiometry (if bilateral hearing loss >35dB refer to ENT)
-consider 3- 6 month course of amoxicillin

Question 7

Otitis media:

What is and how to manage chronic suppurative OM?

Answer 7

OM with >6 weeks of ear discharge suggesting TM perforation

Dry aural toilet 6 times a day with non aminglycoside ear drops

Question 8

Otitis media:

Serious complications of chronic suppurative OM?

Answer 8

• intracranial infections

- mastoiditis