Sandbox:Otitis media classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Otitis media may be classified according to the etiology, duration, physical examination findings, and degree of severity into 3 subtypes: acute, otitis media with effusion, and chronic suppurative otitis media.
Classification
Otitis media can be divided into 3 subtypes, differentiating in their clinical presentation.
Acute Otitis Media
- Acute otitis media (AOM) is primarily caused by viral or bacterial infection due to nasopharyngitis.[1]
- If caused by a virus, it is often self-limited and will typically resolve itself without treatment.[2]
- Antibiotics may be necessary for AOM caused by bacterial infection.
- Symptoms are almost always present and are similar to those from upper respiratory infection, include the following:
- Fever
- Ear pain
- Vomiting
- Diarrhea
- Common cold symptoms
- Mild hearing loss
- Can result in infection-based complications, such as meningitis and mastoiditis.
Otitis Media with Effusion
- Otitis media with effusion (OME) is non-infectiously caused otitis media based on fluid buildup in the eustachian tube.[3]
- It is typically caused by irritants, allergies, or upper respiratory infection that does not infect the ear itself.
- The fluid buildup may remain trapped in the middle ear preceding or following acute otitis media.
- Symptoms typically include partial hearing loss and feelings of "fullness" in the ear, but do not usually present pain, common cold symptoms, fever, or other indicators of illness that is common in AOM.
- OME is usually self-limited and does not require treatment to resolve itself.
Chronic Suppurative Otitis Media
Otitis media with effusion (OME), also called serous or secretory otitis media (SOM), is simply a collection of fluid that occurs within the middle ear space as a result of the negative pressure produced by altered Eustachian tube function. This can occur purely from a viral URI, with no pain or bacterial infection, or it can precede and/or follow acute bacterial otitis media. Fluid in the middle ear sometimes causes conductive hearing impairment, but only when it interferes with the normal vibration of the eardrum by sound waves. Over weeks and months, middle ear fluid can become very thick and glue-like (thus the name glue ear), which increases the likelihood of its causing conductive hearing impairment. Early-onset OME is associated with feeding while lying down and early entry into group child care, while parental smoking, a short period of breastfeeding and greater amounts of time spent in group child care increased the duration of OME in the first two years of life.[4]
Chronic Suppurative Otitis Media
Chronic suppurative otitis media involves a perforation (hole) in the eardrum and active bacterial infection within the middle ear space for several weeks or more. There may be enough pus that it drains to the outside of the ear (otorrhea), or the purulence may be minimal enough to only be seen on examination using a binocular microscope. This disease is much more common in persons with poor Eustachian tube function. Hearing impairment often accompanies this disease.
References
- ↑ Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M (2014). "Update on otitis media - prevention and treatment". Infect Drug Resist. 7: 15–24. doi:10.2147/IDR.S39637. PMC 3894142. PMID 24453496.
- ↑ "Ear infection - acute: MedlinePlus Medical Encyclopedia".
- ↑ "Otitis media with effusion: MedlinePlus Medical Encyclopedia".
- ↑ Owen MJ, Baldwin CD, Swank PR, Pannu AK, Johnson DL, Howie VM (1993). "Relation of infant feeding practices, cigarette smoke exposure, and group child care to the onset and duration of otitis media with effusion in the first two years of life". J. Pediatr. 123 (5): 702–11. PMID 8229477.