The following are the most important diseases or complications that can be caused by otitis media (inflammation of the middle ear):
Respiratory system (J00-J99)
- Sinusitis (inflammation of the paranasal sinuses).
Cardiovascular system (I00-I99)
- Sinus vein thrombosis (SVT)* – occlusion of a cerebral sinus (large venous blood vessels of the brain arising from duraduplications) by a thrombus (blood clot); clinical presentation: headache, congestive papules, and epileptic seizures.
Infectious and parasitic diseases (A00-B99).
- Sepsis (blood poisoning)
Ears – mastoid process (H60-H95)
- Cholesteatoma (synonym: pearl tumor, onion tumor) – ingrowth of multilayered keratinizing squamous epithelium into the middle ear with subsequent chronic purulent otitis media (middle ear infection).
- Hearing loss (sensorineural hearing loss; SNHL) – highest risk in chronic otitis media (14.5 vs. 4.8 per 10,000 person-years) in the first year after otitis diagnosis
- Labyrinthitis – inflammation of a structure of the inner ear called the labyrinth.
- Mastoiditis* (mastoid inflammation), possibly with subperiosteal abscess (abscess formation under the periosteum).
- Tympanic effusion* (synonym: seromucotympanum); accumulation of fluid in the middle ear (tympanum) → middle ear hearing loss; risk of delay in speech development!; no or only a small pain symptomatology; on the frequency: after two weeks, 60-70% of children still have a tympanic effusion, after four weeks 40% and after three months still up to 25%.
- Conduction disorders
- Tinnitus (ringing in the ears) – especially in purulent and serous otitis media (inflammation of the middle ear) after chronic infections.
- Tympanic membrane perforation* (eardrum injury) → (temporary) restriction of hearing.
- Trommelfellruptur (rupture of the eardrum) – heals mostly without consequences.
* Limitation of hearing ability.
Psyche – nervous system (F00-F99; G00-G99)
- Facial nerve palsy, pheripheral* – paralysis of the facial nerve.
- Gradenigo syndrome (pyramidal tip suppuration; suppuration in cavities of the temporal bone) (very rare)
- Brain abscess/intracranial abscess (epidural abscess, subdural abscess) – accumulation of pus in the brain.
- Meningitis (meningitis)
Prognostic factors
- Children with acute otitis media (AOM) and severe tympanic membrane protrusion showed almost twice the risk of treatment failure with antibiotic-free therapy compared with children with moderate, low, or no tympanic membrane protrusion (HR 1.96).
- The peaked tympanograms (A and C curves) at baseline were indicative of better treatment response with antibiotic therapy in multivariate analysis.
