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Otolaryngology (ENT)125 papers

Bacterial otitis media

Last edited: 4/14/2026

Overview

Bacterial otitis media (OM) is an infection of the middle ear characterized by inflammation and fluid accumulation, often leading to symptoms such as ear pain, fever, and hearing impairment. It commonly affects children but can occur in individuals of all ages 10.

Diagnosis

  • Clinical Presentation: Ear pain, fever, irritability, hearing loss, and possibly otorrhea 10.
  • Physical Examination: Tympanic membrane examination for bulging, erythema, opacity, and fluid lines 10.
  • Tympanometry: Measures middle ear pressure and mobility, indicating fluid presence 10.
  • Tuning Fork Tests: Rinne and Weber tests to assess conductive hearing loss 10.
  • Culture and Sensitivity: Recommended for purulent otorrhea to guide antibiotic therapy 10.

    • Management

  • First-Line Antibiotics: Amoxicillin (80-90 mg/kg/day in divided doses for children) for uncomplicated cases 10.
  • Alternative Antibiotics: Amoxicillin-clavulanate or second-generation cephalosporins if resistance or severe infection suspected 10.
  • Pain Management: Acetaminophen or ibuprofen for symptomatic relief 10.
  • Myringotomy and Tympanostomy Tubes: Considered for recurrent or persistent cases 10.
  • Follow-Up: Monitor response to treatment and re-evaluate tympanic membrane status 10.

    • Special Populations

  • Pediatrics: Higher incidence; close monitoring and prompt treatment essential 10.
  • Elderly: Increased risk of complications; careful antibiotic selection to avoid drug interactions 10.
  • Comorbidities: Patients with immunodeficiencies may require broader spectrum antibiotics and closer follow-up 10.

    • Key Recommendations

  • Initiate empirical antibiotic therapy with amoxicillin for uncomplicated bacterial otitis media in children (Evidence: Strong 10).
  • Perform tympanocentesis and culture for purulent otorrhea to guide targeted antibiotic therapy (Evidence: Moderate 10).
  • Consider surgical intervention with tympanostomy tubes for recurrent or persistent cases (Evidence: Moderate 10).
  • Regular follow-up is crucial to assess treatment efficacy and middle ear status (Evidence: Expert opinion 10).

    • References

    1 Azadarmaki R. Office-Based Otology. Otolaryngologic clinics of North America 2025. link 2 Morcos M, Aguilar EC, Zhou A, Ahanotu A, Teng S, Randolph GW et al.. Evidence-Based Medicine in Otolaryngology Part 15: Introduction to Peer Review-A Framework for Clinicians. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2025. link 3 Kurichiyil SH, Whittaker JD, Dalton CL. Face and content validation of artificial temporal bone dissection for otolaryngology training. The Journal of laryngology and otology 2025. link 4 Nwosu OI, Ota M, Goss D, Crowson MG. Automated Technical Skill and Performance Assessment in Otology and Neurotology: A Scoping Review. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 2025. link 5 Shomorony A, Weitzman R, Chen H, Sclafani AP. Augmented otorhinologic evaluation in telemedical visits. American journal of otolaryngology 2024. link 6 Mudry A, Young JR. Centenary memorabilia of Adam Politzer. Journal of medical biography 2022. link 7 Ovrom E, Zemene Y, Gerndt S, Andrade V, Wiedermann J. Cultural Competency and Surgical Decision Making in Otolaryngology. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2022. link 8 Abi Zeid Daou C, Bassim M. Hyaluronic acid in otology: Its uses, advantages and drawbacks - A review. American journal of otolaryngology 2020. link 9 Rubin F, Vellin JF, Berkaoui J, Al Assaf W, Pennica A, Girard B et al.. Impact of the SARS-CoV-2 epidemic on private ENT consulting practice during the first month of lockdown in Réunion Island in 2020. European annals of otorhinolaryngology, head and neck diseases 2020. link 10 Szmuilowicz J, Young R. Infections of the Ear. Emergency medicine clinics of North America 2019. link 11 Wong V, Unger B, Pisa J, Gousseau M, Westerberg B, Hochman JB. Construct Validation of a Printed Bone Substitute in Otologic Education. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 2019. link 12 Çelikoyar MM, Aktas OT. Endoscopy in otolaryngology utilising smartphone as the capturing device. Journal of visual communication in medicine 2018. link 13 Welling DB, Jackler RK. Reflections on the Last 25 Years of the American Otological Society and Thoughts on its Future. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 2018. link 14 Mohan S, Bhattacharyya N. Opioids and the Otolaryngologist: An Ambulatory Assessment. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2018. link 15 Powell J, Powell S, Robson A. A systematic review of patient-reported outcome measures in paediatric otolaryngology. The Journal of laryngology and otology 2018. link 16 Oh SJ, Goh EK, Lee HM, Kong SK, Moon IJ, Chung JW et al.. Application of endoscopy in otology: Changes over the last 8years in Korean Otological Society. American journal of otolaryngology 2018. link 17 Ruben RJ. Otology at the Academy of Gondishapur 200-600 CE. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 2017. link 18 Mudry A. What generated the creation of the Archiv für Ohrenheilkunde, the predecessor of this journal, 150 years ago?. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2015. link 19 Corrales CE, Mudry A. Was Cheselden's One-Century-Long Otological Writings Concordant With His Time?. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 2015. link 20 Robertson PJ, Brereton JM, Roberson DW, Shah RK, Nielsen DR. Choosing wisely: our list. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2013. link 21 Mudry A. The making of a career: Joseph Toynbee's first steps in otology. The Journal of laryngology and otology 2012. link 22 Xu J, Reh DD, Carey JP, Mahesh M, Siewerdsen JH. Technical assessment of a cone-beam CT scanner for otolaryngology imaging: image quality, dose, and technique protocols. Medical physics 2012. link 23 Verwoerd C, Froehlich P, Gryczynska D, Katona G, Pitkaranta A, Blayney A. Pediatric otorhinolaryngology anno 2008: towards European standards for training?. International journal of pediatric otorhinolaryngology 2009. link 24 Yung M, Heyning PV. A prospective multicentre otology database. Advances in oto-rhino-laryngology 2007. link 25 Blackmore KJ, Cocks HC, Bosman DA. A national audit of paediatric service provision in otolaryngology in England and Wales. International journal of pediatric otorhinolaryngology 2007. link 26 Suzuki M, Ogawa Y, Hagiwara A, Yamaguchi H, Ono H. Rapidly prototyped temporal bone model for otological education. ORL; journal for oto-rhino-laryngology and its related specialties 2004. link 27 McGuire JF, Casado B. Proteomics: a primer for otologists. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 2004. link 28 Ohlroggen M, Lustig L. A translation of: The scientific progress of otology in the past decennium (until late 1862) by Hermann Schwartze: pathology and therapy of the external ear. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 2003. link 29 Pothula VB, Jones TM, Lesser TH. Otology in ancient India. The Journal of laryngology and otology 2001. link 30 Mudry A. A history of otology through the development of scientific and medical thought. Acta oto-rhino-laryngologica Belgica 1998. link 31 Kobayashi T, Hinohira Y, Hyodo M, Bredberg G, Alsterborg E. Effects of ionomer cement on guinea pig cochleas. Ear, nose, & throat journal 1997. link 32 Kartush JM. Errors in otology. Ear, nose, & throat journal 1996. link 33 Pappas DG. Otology through the ages. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 1996. link 34 Golding-Wood DG. Temporal bone dissection for display. The Journal of laryngology and otology 1994. link 35 Bleach NR, Williamson PA, Mady SM. Emergency workload in otolaryngology. Annals of the Royal College of Surgeons of England 1994. link 36 Ruby RR, Janzen VD. The changing nature of otological practice in a teaching centre. The Journal of otolaryngology 1984. link 37 Dixon HS. Otolaryngologic plain film radiography, with an emphasis on the temporal bone--how to do it. Part one. The American journal of otology 1982. link 38 Stool SE, Kemper MJ, Kemper B. Adam Politzer, otology and the Centennial Exhibition of 1876. The Laryngoscope 1975. link

    Original source

    1. [1]
      Office-Based Otology. — Azadarmaki R Otolaryngologic clinics of North America (2025)
    2. [2]
      Evidence-Based Medicine in Otolaryngology Part 15: Introduction to Peer Review-A Framework for Clinicians. — Morcos M, Aguilar EC, Zhou A, Ahanotu A, Teng S, Randolph GW et al. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2025)
    3. [3]
      Face and content validation of artificial temporal bone dissection for otolaryngology training. — Kurichiyil SH, Whittaker JD, Dalton CL The Journal of laryngology and otology (2025)
    4. [4]
      Automated Technical Skill and Performance Assessment in Otology and Neurotology: A Scoping Review. — Nwosu OI, Ota M, Goss D, Crowson MG Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (2025)
    5. [5]
      Augmented otorhinologic evaluation in telemedical visits. — Shomorony A, Weitzman R, Chen H, Sclafani AP American journal of otolaryngology (2024)
    6. [6]
      Centenary memorabilia of Adam Politzer. — Mudry A, Young JR Journal of medical biography (2022)
    7. [7]
      Cultural Competency and Surgical Decision Making in Otolaryngology. — Ovrom E, Zemene Y, Gerndt S, Andrade V, Wiedermann J Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2022)
    8. [8]
      Hyaluronic acid in otology: Its uses, advantages and drawbacks - A review. — Abi Zeid Daou C, Bassim M American journal of otolaryngology (2020)
    9. [9]
      Impact of the SARS-CoV-2 epidemic on private ENT consulting practice during the first month of lockdown in Réunion Island in 2020. — Rubin F, Vellin JF, Berkaoui J, Al Assaf W, Pennica A, Girard B et al. European annals of otorhinolaryngology, head and neck diseases (2020)
    10. [10]
      Infections of the Ear. — Szmuilowicz J, Young R Emergency medicine clinics of North America (2019)
    11. [11]
      Construct Validation of a Printed Bone Substitute in Otologic Education. — Wong V, Unger B, Pisa J, Gousseau M, Westerberg B, Hochman JB Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (2019)
    12. [12]
      Endoscopy in otolaryngology utilising smartphone as the capturing device. — Çelikoyar MM, Aktas OT Journal of visual communication in medicine (2018)
    13. [13]
      Reflections on the Last 25 Years of the American Otological Society and Thoughts on its Future. — Welling DB, Jackler RK Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (2018)
    14. [14]
      Opioids and the Otolaryngologist: An Ambulatory Assessment. — Mohan S, Bhattacharyya N Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2018)
    15. [15]
      A systematic review of patient-reported outcome measures in paediatric otolaryngology. — Powell J, Powell S, Robson A The Journal of laryngology and otology (2018)
    16. [16]
      Application of endoscopy in otology: Changes over the last 8years in Korean Otological Society. — Oh SJ, Goh EK, Lee HM, Kong SK, Moon IJ, Chung JW et al. American journal of otolaryngology (2018)
    17. [17]
      Otology at the Academy of Gondishapur 200-600 CE. — Ruben RJ Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (2017)
    18. [18]
      What generated the creation of the Archiv für Ohrenheilkunde, the predecessor of this journal, 150 years ago? — Mudry A European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (2015)
    19. [19]
      Was Cheselden's One-Century-Long Otological Writings Concordant With His Time? — Corrales CE, Mudry A Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (2015)
    20. [20]
      Choosing wisely: our list. — Robertson PJ, Brereton JM, Roberson DW, Shah RK, Nielsen DR Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2013)
    21. [21]
      The making of a career: Joseph Toynbee's first steps in otology. — Mudry A The Journal of laryngology and otology (2012)
    22. [22]
      Technical assessment of a cone-beam CT scanner for otolaryngology imaging: image quality, dose, and technique protocols. — Xu J, Reh DD, Carey JP, Mahesh M, Siewerdsen JH Medical physics (2012)
    23. [23]
      Pediatric otorhinolaryngology anno 2008: towards European standards for training? — Verwoerd C, Froehlich P, Gryczynska D, Katona G, Pitkaranta A, Blayney A International journal of pediatric otorhinolaryngology (2009)
    24. [24]
      A prospective multicentre otology database. — Yung M, Heyning PV Advances in oto-rhino-laryngology (2007)
    25. [25]
      A national audit of paediatric service provision in otolaryngology in England and Wales. — Blackmore KJ, Cocks HC, Bosman DA International journal of pediatric otorhinolaryngology (2007)
    26. [26]
      Rapidly prototyped temporal bone model for otological education. — Suzuki M, Ogawa Y, Hagiwara A, Yamaguchi H, Ono H ORL; journal for oto-rhino-laryngology and its related specialties (2004)
    27. [27]
      Proteomics: a primer for otologists. — McGuire JF, Casado B Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (2004)
    28. [28]
      A translation of: The scientific progress of otology in the past decennium (until late 1862) by Hermann Schwartze: pathology and therapy of the external ear. — Ohlroggen M, Lustig L Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (2003)
    29. [29]
      Otology in ancient India. — Pothula VB, Jones TM, Lesser TH The Journal of laryngology and otology (2001)
    30. [30]
      A history of otology through the development of scientific and medical thought. — Mudry A Acta oto-rhino-laryngologica Belgica (1998)
    31. [31]
      Effects of ionomer cement on guinea pig cochleas. — Kobayashi T, Hinohira Y, Hyodo M, Bredberg G, Alsterborg E Ear, nose, & throat journal (1997)
    32. [32]
      Errors in otology. — Kartush JM Ear, nose, & throat journal (1996)
    33. [33]
      Otology through the ages. — Pappas DG Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (1996)
    34. [34]
      Temporal bone dissection for display. — Golding-Wood DG The Journal of laryngology and otology (1994)
    35. [35]
      Emergency workload in otolaryngology. — Bleach NR, Williamson PA, Mady SM Annals of the Royal College of Surgeons of England (1994)
    36. [36]
      The changing nature of otological practice in a teaching centre. — Ruby RR, Janzen VD The Journal of otolaryngology (1984)
    37. [37]
      Otolaryngologic plain film radiography, with an emphasis on the temporal bone--how to do it. Part one. — Dixon HS The American journal of otology (1982)
    38. [38]
      Adam Politzer, otology and the Centennial Exhibition of 1876. — Stool SE, Kemper MJ, Kemper B The Laryngoscope (1975)
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