Sandbox: Otitis media natural history, complications, and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.
Overview
Natural History
- Onset of otitis media rapidly follows the onset of the causative nasopharyngitis.[1]
- Without treatment, acute otitis media (AOM) will usually resolve between 7 and 14 days.[2]
- 80% of children with AOM will experience symptomatic relief without treatment within 2-3 days.
- Otorrhea will usually take longer than symptoms such as fever or ear pain to resolve.[2]
- Otitis media with effusion (OME) will resolve itself without treatment in a period of 3-6 months.[2]
- Complete clearance of middle ear effusion will take longer than symptomatic effects of otitis media due to longer duration of fluid drainage.
- Chronic suppurative otitis media will not usually resolve itself and will remain and recur indefinitely without surgical intervention.[3]
- Symptoms of acute otitis media will recur indefinitely, heightening risk of complications.
Complications
- Complications of otitis media result from the spread of causative infection, as well as damage to the tympanic membrane due to fluid buildup and pressure changes.
- Intracranial and extracranial complications of otitis media include the following:[4]
- Meningitis: the pathogen causing otitis media can spread to the meninges and cause inflammation.
- Brain abscess: result of inflammation from infection spreading to the brain.
- Mastoiditis: infection of the mastoid bone behind the ears caused by the otitis media pathogen.[5]
- Sigmoid sinus thrombosis: otitis media can result in thrombosis of the cerebral veins and sinuses in rare cases.[6]
- Partial hearing loss.[7]
- Tympanic injury requiring surgical reconstruction.[7]
Prognosis
References
- ↑ Coticchia JM, Chen M, Sachdeva L, Mutchnick S (2013). "New paradigms in the pathogenesis of otitis media in children". Front Pediatr. 1: 52. doi:10.3389/fped.2013.00052. PMC 3874850. PMID 24400296.
- ↑ 2.0 2.1 2.2 Rosenfeld, Richard M.; Kay, David (2010). "Natural history of untreated otitis media". The Laryngoscope. 113 (10): 1645–1657. doi:10.1097/00005537-200310000-00004. ISSN 0023-852X.
- ↑ "www.who.int" (PDF).
- ↑ Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M (2014). "Update on otitis media - prevention and treatment". Infect Drug Resist. 7: 15–24. doi:10.2147/IDR.S39637. PMC 3894142. PMID 24453496.
- ↑ "Mastoiditis: MedlinePlus Medical Encyclopedia".
- ↑ Ropposch T, Nemetz U, Braun EM, Lackner A, Tomazic PV, Walch C (2011). "Management of otogenic sigmoid sinus thrombosis". Otol. Neurotol. 32 (7): 1120–3. doi:10.1097/MAO.0b013e31822a1ec0. PMID 21817936.
- ↑ 7.0 7.1 Harmes KM, Blackwood RA, Burrows HL, Cooke JM, Harrison RV, Passamani PP (2013). "Otitis media: diagnosis and treatment". Am Fam Physician. 88 (7): 435–40. PMID 24134083.