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Otitis media

By Dr. Hamdy Zakaria Mohamed, ENT Specialist Published: July 07, 2026

Otitis media

 Otitis media is inflammation of the middle ear. The term includes several
different disease entites. A good understanding of terms is essential.

Acute otitis media

Acute otitis media (AOM) is a short-lived (usually 1–5 days) infection of the middle ear. If it is viral it may last as little as a day or so but it can persist, causing pus to accumulate under pressure behind the eardrum, which may perforate (Fig. 7.1). Before the eardrum perforates, AOM is intensely painful. It mainly occurs in children.
Recurrent otitis media (ROM) refers to repeated such episodes, typically more than three in a 6-month period.

Otitis media with effusion

Otitis media with effusion (OME) is also common in children. Fluid  often thick sticky ‘glue’ – accumulates in the middle ear behind an intact drum. Because some fluid in the middle ear is normal for up to several weeks after an episode of AOM, the term OME requires that the fluid be persistent for at least 3 months.

Chronic otitis media

This implies that the eardrum has perforated, the perforation has failed to heal and there is ongoing infection. The term chronic suppurative otitis media (CSOM) is of- ten used to emphasize the tendency for ears with longstanding perforations to become infected and discharge.

Algorithm to show outcomes of AOM

Cholesteatoma

Cholesteatoma is the accumulation of squamous epithelium in the middle ear, usually in an ear with a longstanding perforation. This is the most serious form of CSOM.

References

  • StatPearls (NCBI Bookshelf):
    Danishiar, N. and Ashurst, J.V. (2023). Acute Otitis Media. [online] NCBI Bookshelf (StatPearls Publishing). Available at: nih.gov [Accessed 1 Aug. 2026].
  • Medscape:
    Maroldi, R. and Mukherji, S.K. (2024). Complications of Otitis Media. [online] Medscape Drugs & Diseases. Available at: medscape.com [Accessed 1 Aug. 2026].
  • Mayo Clinic:
    Mayo Clinic Staff (2024). Ear infection (middle ear): Symptoms & causes. [online] Mayo Clinic. Available at: mayoclinic.org [Accessed 1 Aug. 2026].
  • MSD Manuals:
    Brazier, M.D. (2024). Otitis Media (Acute). [online] MSD Manual Professional Version. Available at: msdmanuals.com [Accessed 1 Aug. 2026].
  • PubMed Central (PMC):
    Kuczkowski, J., Miłońska, A. and Stodulski, D. (2022). Complications of otitis media – a potentially lethal problem still present. Postępy Dermatologii i Alergologii, [online] 39(4), pp. 643–648. Available at: nih.gov [Accessed 1 Aug. 2026].

Medical Disclaimer

Important Notice: This article is provided for educational and informational purposes only and does not constitute medical advice, diagnosis, or treatment. The content is based on current medical literature and guidelines but should not replace professional medical consultation.

Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read in this article. If you think you may have a medical emergency, call your doctor or emergency services immediately.

Individual responses to treatments may vary. What works for one person may not work for another. Treatment decisions should be made in consultation with qualified healthcare professionals who can evaluate your specific situation.





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Dr. Hamdy Zakaria Mohamed, ENT Specialist

Dr. Hamdy Zakaria Mohamed

MBBCh, Cairo University | Diploma in Otolaryngology, Ain Shams University

Board-certified ENT Specialist providing evidence-based medical care for patients in Suez, Egypt. All medical content is personally reviewed by Dr. Hamdy.

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