New concepts in otitis media.

Pneumatic otoscopy increases the physician's diagnostic acumen. Movement of the tympanic membrane is observed and measured more precisely by tympanometry and acoustic impedance. Ampicillin-resistant strains of Hemophilus influenzae are appearing. It is possible to detect these with deep nasopharyngeal cultures. New reports show the value of antimicrobial prophylaxis in recurrent otitis media. High-risk populations that deserve special attention are children with cleft palate and Down's syndrome.