Otitis media physical examination

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

Overview

The most indicative signs of otitis media are revealed through otoscopic examination of the middle ear and include erythema, bulging, cloud appearance, and immobility of the tympanic membrane. The presence of effusion is also indicative of otitis media. Partial hearing loss from fluid buildup is indicative of otitis media, revealed by tympanometry. Acute otitis media patients are usually ill-appearing and usually present with low-grade fever. Otitis media with effusion patients are usually well-appearing since the condition is not usually associated with common cold symptoms.

Physical Examination

Appearance of the Patient

Acute otitis media: patient is usually ill-appearing due to the usually-accompanying common cold symptoms.^[1]
Otitis media with effusion: patient is usually well-appearing.^[2]

Ears

Otoscopic examination of the ears may reveal the following signs indicative of otitis media:^[3]
- Erythema of the middle ear.
- Presence of effusion.^[4]
- Bulging of the tympanic membrane in otitis media with effusion.
- Cloudy appearance of the tympanic membrane.
- Immobility of the tympanic membrane.
- Tympanic membrane perforation.
Tympanometry may reveal hearing loss due to effusion, as measured by abnormally large reflection of sound due to elevated pressure from fluid buildup.^[4]

Vital Signs

Low-grade fever is usually present in acute otitis media patients.

References

↑ “Ear infection – acute: MedlinePlus Medical Encyclopedia”.
↑ “Otitis media with effusion: MedlinePlus Medical Encyclopedia”.
↑ Rettig E, Tunkel DE (2014). “Contemporary concepts in management of acute otitis media in children”. Otolaryngol. Clin. North Am. 47 (5): 651–72. doi:10.1016/j.otc.2014.06.006. PMC 4393005. PMID 25213276.
↑ ^4.0 ^4.1 Parlea E, Georgescu M, Calarasu R (2012). “Tympanometry as a predictor factor in the evolution of otitis media with effusion”. J Med Life. 5 (4): 452–4. PMC 3539835. PMID 23346249.

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[urlEar_infection_-_acute:_MedlinePlus_Medical_Encyclopedia-1] “Ear infection – acute: MedlinePlus Medical Encyclopedia”.

[urlOtitis_media_with_effusion:_MedlinePlus_Medical_Encyclopedia-2] “Otitis media with effusion: MedlinePlus Medical Encyclopedia”.

[pmid25213276-3] Rettig E, Tunkel DE (2014). “Contemporary concepts in management of acute otitis media in children”. Otolaryngol. Clin. North Am. 47 (5): 651–72. doi:10.1016/j.otc.2014.06.006. PMC 4393005. PMID 25213276.

[pmid23346249-4] 4.0 ^4.1 Parlea E, Georgescu M, Calarasu R (2012). “Tympanometry as a predictor factor in the evolution of otitis media with effusion”. J Med Life. 5 (4): 452–4. PMC 3539835. PMID 23346249.

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