Otitis media is an umbrella term that refers to inflammation of the middle ear. This condition is more common among children 0-8, with the highest occurrence during the first 5 years of life. This is not to say that older children, adolescents or adults are immune, however, the incidence in these last three age groups is minimal. One reason is that the Eustachian tube is almost horizontal in the newborn and infant and young child, but is much more vertical in the teenager and adult population. The Eustachian tubes (there are two of them) when functioning properly, help equalize the air pressure in the middle ear so that it is the same as atmospheric pressure in the outer ear canal. When the Eustachian tubes malfunction the result is an absorption of the oxygen in the middle ear by mucosal cells that line the cavity. In return for the oxygen the cells exude fluid. The longer the Eustachian tube malfunctions, the greater the accumulation of fluid in the middle ear.If the fluid is clear or honey colored, it is called serous otitis media. If the fluid is creamy or mild colored it is likely due to a build up of pus (by product of bacterial growth. This latter condition, if not treated can result in a great deal of pain for the patient and in the worst case scenario cause a perforation of the tympanic membrane. Treatment is usually antibiotcs. IF the tympanic membrane is bulging, an ENT can remedy the situation and immediately relieve the pain by a simple outpatient procedure known as a myringotomy.
Fortunately today ENTs and audiologists can recognize otitis media through visual inspection of the outer ear and tympanic membrane using a procedure called otoscopy. This is a simple examination using a small lighted (usually hand-held) scope with a magnifying lens through which the clinician inspects the ear drum and other landmarks. Another test that can assist in the diagnosis is called tympanometry, which be discussed later.