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Ottis Media
Common names: Glue ear
Image Notes: Middle ear anatomy including the ossicles: incus, stapes and malleus.
Otitis media is inflammation of the middle ear: the small space between the ear drum and the inner ear. It is one of the two categories of ear inflammation that can underly what is commonly called an earache, the other being otitis externa. An important fact is that many diseases can cause ear pain other than ear infections, including cancers of any structure that shares nerve supply with the ear, so unexplained ear pain calls for a complete and detailed examination by an otolaryngologist (ear, nose, and throat physician). Otitis media is very common in childhood, with the average toddler having two to three episodes a year, almost always accompanied by a viral upper respiratory infection (URI), also known as the common cold. The rhinoviruses (nose viruses) that cause the common cold infect the eustachian tube that goes from the back of the nose to the middle ear, causing swelling and compromise of pressure equalization, which is the normal function of the tube. In general, the more severe and prolonged the compromise of eustachian tube function, the more severe the consequences are to the middle ear and its delicate structures. If a person is born with poor eustachian tube function, this greatly increases the likelihood of more frequent and severe episodes of otitis media. Progression to chronic otitis media is much more common in this group of people, who often have a family history of middle ear disease.
Types
Otitis media has many degrees of severity, and various names are used to describe each. The terminology is sometimes confusing because of multiple terms being used to describe the same condition.
- Acute otitis media is most often purely viral and self-limited, as is its usual accompanying viral URI. There is congestion of the ears and perhaps mild discomfort and popping, but the symptoms resolve with the underlying URI. If the middle ear, which is normally sterile, becomes contaminated with bacteria, pus and pressure in the middle ear can result, and this is called acute bacterial otitis media. Viral acute otitis media can lead to bacterial otitis media in a very short time, especially in children, but it usually does not. The publicized debate about whether to treat acute otitis media with antibiotics centers around the distinction between viral cases, which do not respond to antibiotics, and bacterial cases, which do respond to antibiotics. The individual with bacterial acute otitis media has the classic "earache", pain that is more severe and continuous and is often accompanied by fever of 102 degrees or more. Bacterial otitis media should be treated with appropriate antibiotics, which usually relieve the pain within a few hours. Without antibiotic treatment, acute otitis media can progress to cause perforation of the eardrum, mastoiditis, or even meningitis, a potentially fatal disease.
- Ottis media with effusion (fluid collection), also called serous Otitis Media or secretory Otitis Media, 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. Effusions of the middle ear that cause significant hearing impairment and do not resolve can be treated by making a small incision in the eardrum (myringotomy) and inserting a specially designed plastic or metal tube, a procedure performed by an otolaryngologist (ear, nose, and throat specialist), or by an otologist (ear specialist).
- Chronic suppurative otitis media is a term applied when there is 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.
Text and images are licensed under the GNU Free Documentation License. Material is used from the Wikipedia article "Ottis media".
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