Acute vs chronic otitis media Acute Otitis Media (AOM) Acute otitis media (AOM) is an inflammatory condition of the middle ear, often caused by infection. Here are the key points about AOM: Clinical Features : Symptoms : AOM typically presents with ear pain , fever , and sometimes discharge from the ear . In infants, watch out for crying , ear pulling , and sleeplessness . Eustachian Tube Dysfunction : Dysfunction of the Eustachian tube (the tube connecting the middle ear to the back of the throat) leads to fluid retention in the middle ear, which can become infected. Risk Factors : Common cold, flu, sinus infections, allergies, and smoking can contribute to AOM. Complications : If left untreated, AOM can lead to: Hearing loss due to rupture of the tympanic membrane (eardrum). Otitic meningitis : Infection spreading to the meninges (membranes covering the brain). Brain abscess . Dural sinus thrombosis : Clot formation in the dural venous sinuses. Tympanic membrane rupture due to pus accumulation . Treatment : Antibiotics (such as amoxicillin, erythromycin, or azithromycin) are used to treat the infection. Analgesics (like ibuprofen) manage pain, and antipyretics (such as paracetamol) control fever. In severe cases, a procedure called tympanostomy (inserting a small tube into the middle ear) may be necessary to prevent fluid accumulation . Chronic Otitis Media (COM) Chronic otitis media refers to persistent or recurrent ear discharge lasting more than 6 weeks. There are two main types: Chronic Mucosal Otitis Media (Mucosal COM) : Pathophysiology : Develops due to chronic inflammation secondary to a perforation in the tympanic membrane . Clinical Features : Patients present with a chronically discharging ear without fever or ear pain. Examination reveals a visible tympanic membrane perforation . Risk Factors : Recurrent acute otitis media, previous traumatic perforation, grommet insertion, and craniofacial abnormalities. Hearing Loss : Usually conductive hearing loss. Investigations : Audiograms, tympanometry, and microbiological swabs. Management : Antibiotics, addressing risk factors, and surgical options if needed . Chronic Suppurative Otitis Media (Squamous COM) : Associated with cholesteatoma , which forms due to retraction of the tympanic membrane. Requires surgical management to remove the cholesteatoma and repair the tympanic membrane. Complications of Chronic Otitis Media : Intratemporal : Involving structures near the infection site. Extratemporal : Extracranial or intracranial complications. These can include mastoiditis, facial nerve palsy, labyrinthitis, and intracranial abscesses