Medical Health Encyclopedia

Neither tympanometry nor reflectometry are substitutes for the pneumatic otoscope, which allows a direct view of the middle ear.

Findings Indicating AOM or OME. A diagnosis of AOM requires all three of the following criteria:

• History of recent sudden symptoms. Symptoms may include fever, pulling on the ear, pain, irritability, or discharge (otorrhea) from the ear.
• Presence of fluid in the middle ear. This may be indicated by fullness or bulging of the eardrum or limited mobility.
• Signs and symptoms of inflammation. These may include redness of the eardrum as well as assessment of the child's discomfort. Ear pain that is severe enough to interfere with sleep may indicate inflammation.

AOM (fluid and infection) is often difficult to differentiate from OME (fluid without infection). It is important for a doctor to make this distinction as OME does not require antibiotic treatment. In patients with OME, an air bubble may be visible and the eardrum is often cloudy and very immobile. A scarred, thick, or opaque eardrum may make it difficult for the doctor to distinguish between acute otitis media and OME.

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Severity of AOM: Acute otis media is characterized as severe or non-severe.

• Non-severe AOM: Mild-to-moderate pain, temperature less than 102.2 degrees F (39 degrees C).
• Severe AOM: Moderate-to-severe pain, temperature of 102.2 degrees F (39 degrees C) or higher.

Home Diagnosis

Parents can also use a sonar-like device, such as the EarCheck Monitor, to determine if there is fluid in their child's middle ear. EarCheck employs acoustic reflectometry technology which bounces sound waves off the eardrum to assess mobility. When fluid is present behind the middle ear ( a symptom of AOM and OME), the eardrum will not be as mobile. The device works like an ear thermometer and is painless. Results indicate the likelihood of the presence of fluid and may help patients decide whether they need to contact their child's doctor.

Tympanocentesis