Acute Otitis Media: Otoscopic Findings

Acute otitis media can take on a variety of appearances with a range of different colors. Otoscopic findings include alterations in translucency, position, and mobility; and other features such as air bullae, fluid levels, and perforations. Erythema of the tympanic membrane is a common finding in patients with acute otitis media, however it is NOT by itself diagnostic of an infection. Patients with a cough or a fever may also be noted to have a reddened eardrum. Appreciation of the limitation of this finding is important in the prevention of inappropriate antibiotic prescription. This second example features a bulging tympanic membrane, which is the hallmark of acute otitis media. It is the single most specific sign of an infection of the middle ear. This third tympanic membrane is bulging, opaque, and covered by a thing layer of discharge. This combination of findings is highly predictive of acute otitis media. Opacity or cloudiness can also be seen in otitis media with effusion and cannot in isolation be used to distinguish between the two conditions. The fourth example features air bullae, which is indicative of bullous myringitis, an ear infection that can be exquisitely painful. In addition to these findings, immobility detected by pneumatic otoscopy can provide evidence of a middle ear effusion. This can be particularly helpful in cases where the tympanic membrane is in a neutral position and yet appears to be inflamed.

0:00 Intro
0:17 Erythema
0:36 Bulging tympanic membrane
0:47 Bulging and opaque tympanic membrane
1:04 Air bullae

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Видео Acute Otitis Media: Otoscopic Findings канала Medical Education for Visual Learners