# Otitis Media --- **Otitis media** or sometimes **acute otitis media** (**AOM**) is an infection of the [[ears|middle ear]] that lasts less than 6 weeks. This is common in infants and children because of [[ears#Considerations for Pediatrics|how their ears are shaped]] (it's the #1 reason for antibiotic proscription in children). AOM causes the [[ears|eustachian tubes]] to become blocked, which traps fluid in the middle ear, which is quite painful. ## Causes Otitis media often occurs in conjunction with an upper respiratory infection. The root causes can be: - bacterial - the *[[Haemophilus influenzae|H. influenzae]]* bacteria - viral - rhinosinusitis - allergic rhinitis ## Signs & Symptoms - otalgia (severe, deep throbbing pain/fullness in the ears) - fever - conductive [[hearing|hearing loss]] - bulging tympanic membrane - ear drainage ## Treatment The treatment for otitis media is to proscribe [[decongestants]] until the swelling in the ears goes down and broad spectrum to treat the root cause if it's bacterial in origin. If there is drainage in the ears the ABX can be administered by ear drops. In severe cases they can perform a surgical procedure called a **myringotomy**. This is an incision made in the tympanic membrane under local anesthetic. The goal of a myringotomy is to release the pressure on the membrane, and to drain any purulent fluid from the middle ear. The incision typically heals in 24-72 hours. If not contraindicated, tubes be placed in the incision to keep it from closing; these typically come out on their own in 6-18 months. ## Prevention There are several steps that can be taken to reduce the risk of developing otitis media in children. - encourage [[breastfeeding]]/using a pacifier - avoid tobacco smoke - avoid group day care - avoid allergens # Chronic Otitis Media If acute otitis media is not treated or does not respond to treatment for long enough it may cause irreversible damage, such as perforation of the ear drum or cholesteatoma (whatever that is). The symptoms of chronic otitis media are CHL and otorrhea (a foul-smelling drainage) Treatment for chronic otitis media are antibiotics and several surgical options, such as: - tympanoplasty - ossiculoplasty - mastoidectomy ___