Otitis media is inflammation of the middle ear. Acute otitis media is a rapid onset infection in the middle ear shown by symptoms like ear pain, discharge from the ear, fever, loss of appetite, vomiting or diarrhea. Recurrent otitis media is defined as more than 3 episodes in 3 months or more than 4 episodes in 6 months. The pathogenesis involves infection and dysfunction of the Eustachian tube, which normally equalizes pressure and drains secretions from the middle ear. Dysfunction impairs these functions and allows bacteria and viruses to enter and the host response causes inflammation.

1. OTITIS MEDIA

2. Definition
Otitis media : inflammation of the middle ear without
reference to etiology or pathogenesis
Acute otitis media : inflammation of the middle ear with
rapid onset of one or more local or systemic signs and
symptoms of acute infection within the middle ear (otalgia,
otorrhea, fever, anorexia, vomiting or diarrhea)
Recurrent otitis media (5 to 10% of children)
– > 3 episodes of AOM in 3 months with evidence of cure
between episodes
– > 4 episodes of AOM in 6 months

3. Acute otitis media Normaal TV
Acute otitis media

4. Otitis media met efusie – secretoire otitis media
glue ear …

5. 5. Pathogenesis of OM
Infection ET dysfunction
Host respons
Liberation of inflammatory mediators
Increase of vascular permeability
Increase of glandular secretion
Inflammation Mucosal proliferation

6. 1. Role of the Eustachian Tube
1. Pressure regulation of
middle ear
2. Clearance ‘Drainage’ of
middle ear secretions
mucociliary
muscular
3. Protection from sound and
secretion
anatomic
immunologic and mucociliairy

7. Eustachian tube
• Usually closed
• Opens during swallowing, yawning, and
sneezing
• Opening involves cartilaginous portion
• Tensor veli palatini responsible for active
tubal opening
• No constrictor function

8. Dysfunction : 1. Impairment of pressure regulation
Functional obstruction
Open Weak TVP Obstruction
Anatomic obstruction
Inflammation adenoid
Tumor
Intrinsic Extrinsic
After Bluestone

9. Infection ET dysfunction
Host respons
Liberation of inflammatory mediators
Increase of vascular permeability
Increase of glandular secretion
Inflammation Mucosal proliferation