Diagnosis and management of middle ear disease in children

Abstract

Otitis media is a common childhood condition and refers to inflammation of the middle ear. It encompasses a spectrum of diseases including acute otitis media, otitis media with effusion (‘glue ear’) and chronic otitis media which are both common in childhood. This short article offers practical advice about how to evaluate and manage otological presentations. A careful history and examination are essential in children presenting with ear problems. Parents and children should be asked about pain, discharge, hearing loss, delays in speech or learning, reports of tinnitus and balance concerns. Examination includes evaluation of the pinna and mastoid, otoscopy evaluating the ear canal and tympanic membrane alongside nose, throat and neck examination. The management of otitis media differs according to the disease subtype. In acute otitis media, the mainstay of treatment is conservative or medical. Glue ear treatment initially involves active monitoring; surgical intervention or hearing rehabilitation is required in a proportion of cases. In chronic otitis media, non-surgical and surgical options are tailored to the disease under specialist care.