AOM - Acute otitis media

Acute otitis media is one of the most common conditions in ENT practice, both in adults and in children.

How does an ear infection occur?

Acute otitis media is an infection that starts in less than 3 weeks. The most common bacteria are: S. pneumoniae, H. influenzae, Moraxella catarrhalis, Gram-negative bacilli and group B hemolytic streptococci.

The infection leads to inflammation of the middle ear, which is the cavity behind the eardrum and which communicates through the Eustachian tube with an area behind the nose called the cavum. The mechanism of the disease is the dysfunction of the Eustachian tube, which will lead to the creation of negative pressure in the middle ear, the accumulation of fluid in this space and the appearance of an infection.


  • otalgia (painful sensation in the ear)
  • the feeling of fullness or liquid in the ear
  • noise in the ear (tinnitus)
  • sometimes fever


In order to get the correct diagnosis, you need to go to an ENT consultation, during which the ear is examined using an otoscope.


Treatment is in the first medical phase, with 60% of cases resolving spontaneously within the first 48-72 hours.

Differential treatment:

  • symptomatic treatment (anti-inflammatory, analgesic, drops) if the otitis is uncomplicated and the evolution is favorable
  • local treatment with antibiotic drops, if the eardrum is perforated
  • oral antibiotic treatment, if otitis is in the perforating, suppurating stage or if the symptoms do not disappear

When is surgical treatment indicated?

In some cases, for children, surgical treatment may be necessary. Myringotomy (tubes in the ears) is indicated in:

  • recurrent otitis media – more than 3 episodes in 6 months or more than 4 episodes per year – with fluid in the tympanic cavity at the time of examination
  • chronic presence of fluid in the tympanic cavity (more than 3 months)
  • when the patient does not respond to antibiotic treatment or is immunocompromised
  • in children aged 1 to 4 years with recurrent ear infections or chronic adenoiditis.


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