Otitis Media

Otitis media is inflammation of the middle ear, usually following a viral or bacterial infection of the upper respiratory tract. It is most common in children, particularly atopic children, because their shorter and more horizontal Eustachian tubes drain poorly and obstruct easily. Contributing factors include dairy intake in sensitive individuals, disturbances of the upper-respiratory microbiome, and sympathetic nervous system activation that may impair normal Eustachian tube function and mucosal drainage.

Common features include ear pain, a sensation of fullness or pressure in the ear, and reduced hearing. Fever, irritability, and disturbed sleep are frequent in children, who may tug or rub at the affected ear. If the eardrum perforates, there may be discharge of fluid or pus from the ear canal, often with sudden relief of pain.

Diagnosis is clinical and based on otoscopic examination, which may reveal a red, bulging, or dull tympanic membrane with loss of the normal light reflex. Reduced mobility of the eardrum and visible fluid behind it support the diagnosis.

Recurrent or persistent otitis media can lead to chronic middle-ear effusion (glue ear) with associated hearing loss and, in children, delays in speech and language development. Less commonly, complications include tympanic membrane perforation and mastoiditis.