Synonyms in a broader sense
Medical: Acute otitis media, chronic inflammation of the middle ear, hemorrhagic otitis media, myringitis bullosa
Definition Otitis media
Otitis media is a disease of the middle ear caused by bacteria or viruses in the spaces inside the ear that belong to the middle ear. Occurrence in the populationMostly small children up to the age of two years are affected. At this age, otitis media is extremely common, so that 80-90% of all children fall ill once, and about a third also several times.
Symptoms
The most common complaints are pulsating earaches and hearing loss. The latter is caused by an effusion of purulent fluid into the tympanic cavity, the space between the eardrum and the inner ear, which is the most important structure of the middle ear. The accumulation of fluid in the tympanic cavity leads to attenuation of the sound reaching the inner ear via the outer ear canal, so that sufficient signal processing by the inner ear to produce the auditory impression is no longer guaranteed.
As a result of the tympanic cavity effusion, a feeling of pressure or noise in the ear is also often experienced. This explains the phenomenon often observed in sick children who often touch the ear (hence the name “ear compulsion”). In about one third of the cases, the tympanic cavity effusion resorbs itself, so that no medical intervention is necessary. Another characteristic feature of otitis media is the so-called tragus pain, which occurs when pressure is applied to the small cartilage of the ear below the external auditory canal.
- Helix
- Antihelix
- Tragus
- Antitragus
Symptoms and signs
Especially in younger children, however, ear problems are not the main focus; rather, more unspecific general symptoms and signs such as malaise, loss of appetite and nausea (gastrointestinal complaints) dominate. Often a fever then also occurs (usually
< 38°C). The course of the disease is variable: if the eardrum is ruptured, the earache is relieved spontaneously, and secretions (purulent fluid) may flow from the external auditory canal (this is called otorrhea, Greek for “running ear”).
The majority of middle ear infections heal without any consequences if treated appropriately (see below). If the disease occurs more than six times in one year, the ENT (ear, nose and throat specialist) will refer to the middle ear inflammation as recurrent otitis media and the cause should be clarified (e.g. whether enlarged pharyngeal tonsils, medically known as adenoids = polyps, are present which cause a ventilation problem in the middle ear and thus promote the growth of bacteria). The ear, nose and throat physician is informed by the typical symptoms of inflammation of the middle ear (hearing loss, pressure pain, possible fever and malaise) and characteristic changes in the eardrum.
The diagnosis is confirmed by means of the so-called otoscopy, an observational examination of the external auditory canal, eardrum and partly also the tympanic cavity. The eardrum, which in healthy persons is shiny, transparent and smooth like mother-of-pearl, appears reddened, clogged and loosened. The position of the light reflex, which is reflected by a lamp through the normally reflective eardrum, can also be used to detect changes in the position of this thin membrane: While the light reflex is normally located in the lower anterior region, in middle ear inflammation the reflex shifts towards the central hammer handle or the reflex is missing completely. (Note for better understanding: the hammer handle is a part of the first of the three ossicles – hammer, anvil and stapes – which transmit sound from the eardrum to the inner ear).
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