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Acute Otitis Media

Definitions

Acute otitis media with effusion (AOME) is a clinically identifiable, suppurative infection of the middle ear. The infection has a relatively sudden onset and short duration. It denotes inflammation of the mucoperiosteal lining of the middle ear. The inflamed tympanic membrane (TM) is bulging, opacified, or both.

The condition chronic otitis media is poorly defined, but it may be categorized into two clinical entities for simplification: chronic otitis media with effusion (COME) and chronic suppurative otitis media (CSOM). COME, also known as serous or non-suppurative otitis media, is characterized by the presence of a middle ear effusion (MEE) behind an intact TM that persists for more than 2 to 3 months. It may be asymptomatic except for hearing loss. There generally are no acute clinical signs or symptoms, and the TM is not red or bulging. CSOM is characterized by chronic perforation of the TM, with purulent discharge, for a prolonged period of time, usually more than 6 weeks. There generally is an insidious clinical onset. Either COME or CSOM may follow AOME.

Epidemiology

Otitis media is one of the most frequent causes for physician visits by children. Approximately 25% of such visits during the first year of life are for middle ear disease; this increases to 40% for children 4 to 5 years of age.

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