Otitis media

Acute (suppurative) otitis media is an acute infection of the middle ear, and also mastoid, more commonly seen in children. There is no indication for imaging, unless a complication is suspected, such as mastoiditis, labyrinthitis or petrous apicitis (see petrous apex), or there are signs suggesting an intracranial complication such as meningitis, brain abscess or sigmoid sinus thrombosis.

Chronic otitis media is commonly caused by dysfunction of the eustachian tube, causing serous otitis media (see eustachian tube dysfunction). In adults with persistent otitis media, an exploration of the nasopharynx should be performed, either endoscopically or by imaging, to exclude a tumoral lesion. Chronic otitis media may be associated with cholesteatoma. Chronic otitis media does not necessarily causes irreversible changes in the middle ear. However, it may cause ossicular erosions (most commonly of the long process of the incus), and it may evolve towards fibroadhesive chronic otitis media, causing ossicular fixation (see ossicular chain (VI:2), Fig. 2); in other patients tympanosclerosis may develop.

Also, see granulation tissue ear.

RH