From the Guidelines
An ear with otitis media is characterized by a red, bulging tympanic membrane with decreased mobility, and may exhibit distinct erythema, air fluid level behind the tympanic membrane, or otorrhea, as indicated by the American Academy of Family Physicians and American Academy of Pediatrics guidelines 1. The diagnosis of otitis media is based on the presence of middle-ear effusion and signs or symptoms of middle-ear inflammation, which can be assessed using pneumatic otoscopy, tympanometry, or acoustic reflectometry 1. Key features of otitis media include:
- Bulging of the tympanic membrane
- Limited or absent mobility of the tympanic membrane
- Air fluid level behind the tympanic membrane
- Otorrhea
- Distinct erythema of the tympanic membrane These changes occur due to bacterial or viral infection causing inflammation and fluid buildup in the middle ear space, increasing pressure against the tympanic membrane, as described in the Nature Reviews Disease Primers study 1. In children, the eustachian tube's horizontal orientation and immature function contribute to fluid accumulation and infection, leading to a high prevalence of otitis media, with about 2.2 million diagnosed episodes occurring annually in the United States, as reported in the Otolaryngology--head and neck surgery journal 1. The most recent and highest quality study, published in 2016 in the Nature Reviews Disease Primers, provides a comprehensive overview of otitis media, including its diagnosis, treatment, and management 1.
From the Research
Description of the Ear with Otitis Media
- The ear with otitis media is typically characterized by a "red" ear-drum, as well as bulging and opacification of the ear-drum 2.
- Impaired tympanic membrane mobility on pneumatic otoscopy is also a common finding in patients with otitis media 2.
- The tympanic membrane may appear bulging or retracted, and may have a yellow or white appearance due to the presence of pus or fluid 3.
- In some cases, the ear may also have a foul odor or discharge, particularly if the eardrum has ruptured 3.
Symptoms Associated with Otitis Media
- Ear pain, fever, irritability, and otorrhea are common symptoms of otitis media 3, 2.
- Children with otitis media may also exhibit signs of discomfort, such as rubbing or tugging on the ear 3.
- In severe cases, otitis media can lead to more serious complications, such as tympanic membrane perforation or mastoiditis 4, 5.