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Otitis Media

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Infectious Diseases in Pediatric Otolaryngology

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Abstract

Otitis media is a leading cause of health care visits in the pediatric population and the most frequent reason why children are prescribed antibiotics or undergo surgery. Treatment for OME and AOM are predicated on accurate diagnosis. Increasing effort is being made to be clarify diagnostic criteria to be certain of diagnosis of AOM before prescribing antibiotic therapy so as to reduce antibiotic burden and decrease healthcare expenditure. Despite this, there is no gold standard for the diagnosis of AOM or OME. It is a clinical diagnosis with evolving symptoms based on disease state and progression. The introduction of pneumococcal conjugated vaccines has positively affected the incidence of acute otitis media (AOM), as well as lead to changes in the microbiology of otitis media. The goals of treating AOM are to effectively cure the infection, quickly relieve symptoms, and prevent recurrence and rare complications and to preserve hearing, without significant or severe adverse events. Typically, tympanocentesis is not feasible or desirable, so one must select antibiotic therapy empirically based on the known epidemiology of AOM pathogens. First-line, narrow-spectrum antibiotic choices, such as amoxicillin, still appear to be appropriate in treating routine AOM, with more potent antibiotics reserved for treatment failures. Surgery may be used in select cases.

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Abbreviations

ABR:

Auditory brainstem response

AOM:

Acute otitis media

AR:

Acoustic reflectometry

EAC:

External auditory canal

ELISA:

Enzyme linked immunosorbent assay

HL:

Hearing level

IPD:

Invasive pneumococcal disease

MEE:

Middle ear effusion

OAE:

Otoacoustic emission

OME:

Otitis media with effusion

PCR:

Polymerase chain reaction

PCV:

Pneumococcal conjugate vaccine

PNSP:

Penicillin-nonsusceptible S. pneumoniae

RSV:

Respiratory syncytial virus

TM:

Tympanic membrane

WBR:

Wideband reflectance

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Authors and Affiliations

  1. Division of Otolaryngology–Head and Neck Surgery, University of Connecticut School of Medicine, Connecticut Children’s Medical Center, Hartford, CT, USA

    Christopher R. Grindle M.D.

  2. Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA

    Armando G. Correa M.D.

  3. Texas Children’s Hospital, 6701 Fannin St, Suite 1540, Houston, TX, USA

    Armando G. Correa M.D.

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  1. Christopher R. Grindle M.D.
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Correspondence to Christopher R. Grindle M.D. .

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Editors and Affiliations

  1. Department of Pediatric Otolaryngology, Connecticut Children’s Medical Center, Hartford, Connecticut, USA

    Tulio Valdez

  2. Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA

    Jesus Vallejo

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Grindle, C.R., Correa, A.G. (2016). Otitis Media. In: Valdez, T., Vallejo, J. (eds) Infectious Diseases in Pediatric Otolaryngology. Springer, Cham. https://doi.org/10.1007/978-3-319-21744-4_3

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