Differentiating otitis media from other diseases

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.

Overview

Otitis media must be differentiated from other diseases that cause ear pain or ear itchiness, hearing loss, middle ear discharge, tympanic effusion, and dizziness. This includes otitis externa, myringitis, sinusitis, and Meniere’s disease.

Otitis media must be differentiated from other diseases that cause ear pain or ear itchiness, hearing loss, middle ear discharge, tympanic effusion, and dizziness.:^[1]


Disease	Findings
Otitis externa	Presents with ear pain or ear itching, hearing loss, and suppurative discharge from the ear. Differentiated from otitis media in that the ear pain is felt deep inside the ear and usually worsens with movement. Can also present with fever, difficulty swallowing, and weakness in the face. Treatment requires antibiotics and possible surgery to remove the dead skin. ^[2]
Myringitis	Presents with blisters on the tympanum, leading to ear pain and potential hearing loss. Differentiates from otitis media in that common cold symptoms or fever are not usually present. Treatment requires antibiotics.^[3]
Sinusitis	Presents with fever, weakness, cough, nasal congestion, dizziness, and post-nasal drip. Nasal congestion can result in feelings of “fullness” in the middle ear that can manifest similarly to otitis media. Sinusitis differentiates from otitis media in that there is usually no ear pain or suppurative discharge or tympanic effusion.^[4]
Meniere’s Disease	Presents with severe dizziness, tinnitus, hearing loss, and feelings of “fullness” in the inner ear^[5]. Usually affects individuals between aged 40 and 60 years old. Caused by buildup of fluid in the inner ear. Differentiates from otitis media in that there is usually no ear pain or suppurative discharge, as well as no common cold symptoms.^[6]