Otitis media und ihre Komplikationen

Acute suppurative otitis media is one of the most common infections in childhood, caused by Streptococcus pneumonia, Haemophilus influencae, Staphylococcus or Pneumococcus infection via the Eustachian tube. Occasionally it can be blood-borne during viral or bacterial infections. With the improvement of tubal function as the child grows, the incidence of acute AOM decreases. Acute suppurative otitis media is a severe inflammation of the middle ear mucosa accompanied by severe pain, fever, reddening and bulging of the tympanic membrane which may perforate spontaneously. The course can be variable, but usually resolves without consequences. Diagnosis is made on the basis of otoscopic findings. It is important to promptly recognize possible complications such as mastoiditis, sinus thrombosis and brain abscess, which are rare but threatening situations. Treatment of acute suppurative otitis media consists of the application of topical decongestants, analgesics, antipyretics and antibiotics. In some cases paracentesis and adenoidectomy might be helpful. In the case of complications a surgical procedure is mandatory. As a residuum of acute otitis media a permanent perforation of the eardrum may result in chronic otitis media. Rarely, squamous epithelium may grow through the perforation into the middle ear and thus give rise to a cholesteatoma.