Ear

Otitis Media Diagnosis

search

Otitis Media Diagnosis, Otitis Media Symptoms and Signs

  • Symptoms (reference to Incidence in Otitis Media cases)
  1. Ear Pain (Otalgia) (40-60%)
    1. Predicts <50% of Otitis Media
    2. Predicts 80% of Otitis Media in presence of URI
    3. Only 12% of children "pulling ear" have Otitis Media
    4. Other causes of Otalgia
      1. Upper Respiratory Infection
      2. Cerumen Impaction
      3. Sterile effusion
  2. Rhinitis (90%)
  3. Cough (78%)
  4. Constitutional symptoms (60-80%)
    1. Ill Child
    2. Poor appetite
    3. Irritable
  5. Low-grade fever (22-69%)
    1. Temperature under 101 degrees for <24 hours
  6. Difficult sleeping in infants (35-50%)
  7. Ear Drainage (5%)
    1. Liquefied cerumen from fever or
    2. Pus from perforated Tympanic Membrane
  8. Unilateral Hearing Loss
  9. Upper Respiratory Infection
    1. Incidence of Otitis Media after 5 days of URI: 40%
  1. Color
    1. Cloudy, opacified Tympanic Membrane
      1. Positive Predictive Value: 80%
    2. Red Tympanic Membrane
      1. Multiple causes (Nonspecific finding)
        1. Crying
        2. Viral illness
      2. Positive Predictive Value
        1. Distinctly Red Tympanic Membrane: 65%
        2. Slightly Red Tympanic Membrane: 16%
  2. Position
    1. Tympanic Membrane bulging
      1. Positive Predictive Value: 89%
      2. First occurs in posterosuperior quadrant
      3. TM most compliant in posterosuperior quadrant
    2. Loss of landmarks (Cannot see Umbo) (80% PPV)
    3. Light reflex may be absent from bulging TM
  3. Mobility
    1. TM Immobile by Pneumatic Otoscopy
      1. Test Sensitivity: 94%
      2. Test Specificity: 90%
      3. Positive Predictive Value: 78%
    2. Tympanometry
      1. Normal Tympanogram
        1. No Acute Otitis Media
      2. Middle Ear effusion
        1. Test Sensitivity: 90%
        2. Test Specificity: 80%
        3. Negative Predictive Value: 77%
      3. Precaution
        1. Only Otoscopy can distinguish Acute Otitis Media (AOM) from Otitis Media with Effusion (OME)
  • Images