57, 58, 59 Otitis Media

Otitis Media

Otitis media is inflammation or infection located in the middle ear.

Otitis media is diagnosed in patients with acute onset, presence of middle ear effusion, physical evidence of middle ear inflammation, and symptoms such as pain, irritability, or fever

There are several subtypes of OM, as follows:

  • Acute OM (AOM)
  • OM with effusion (OME)
  • Acute suppurative OM
  • Chronic OM

Every examination should include an evaluation and description of the following four tympanic membrane (TM) characteristics:

  • Color – A normal TM is a translucent pale gray; an opaque yellow or blue TM is consistent with middle-ear effusion (MEE). Look for cone of light
  • Position – In AOM, the TM is usually bulging; in OME, the TM is typically retracted or in the neutral position
  • Mobility – Impaired mobility is the most consistent finding in patients with OME
  • Perforation – Single perforations are most common
Ear anatomy
Normal TM
Bulging TM commonly seen in AOM
AOM with bulging TM and purulent effusion behind the TM
Chronic OM with a retraction pocket of the pars flaccida.
Perforation of the right tympanic membrane resulting from a previous severe acute otitis media


  1. https://emedicine.medscape.com/article/994656-overview
  2. https://teachmesurgery.com/examinations/ent/ear/
  3. Harmes, K.M., Blackwood, R.A., Burrows, H.L., Cooke, J., Harrison, R.V., & Passamani, P.P. (2013). Otitis media: diagnosis and treatment. American family physician, 88 7, 435-40 .