[The infections of the ear]

Area of Science:

• Otolaryngology
• Infectious Diseases
• Pediatrics

Background:

• External otitis, despite treatment, can indicate underlying skull base osteomyelitis, particularly in immunocompromised individuals.
• Acute otitis media (AOM) is a prevalent childhood bacterial infection with varied management strategies.
• Chronic otitis media develops after prolonged AOM episodes and can be mitigated by interventions like grommets.

Purpose of the Study:

• To highlight the importance of considering skull base osteomyelitis in refractory external otitis cases.
• To outline current treatment guidelines for acute otitis media (AOM) in children based on age and symptom severity.
• To emphasize the long-term implications of AOM and its complications, including chronic otitis media and meningitis.

Main Methods:

• Review of clinical presentations and treatment protocols for external otitis and AOM.
• Analysis of antibiotic therapy duration and indications for different AOM severities.
• Discussion of interventions for chronic otitis media and diagnostic approaches for complicated AOM.

Main Results:

• Persistent external otitis necessitates investigation for skull base osteomyelitis, requiring extended parenteral antibiotic therapy.
• Purulent AOM in children under two years mandates amoxicillin for 8-10 days; older children with mild symptoms may benefit from symptomatic treatment.
• Grommets can decrease AOM recurrence, and AOM with meningitis requires audiogram and MRI monitoring.

Conclusions:

• Early recognition and aggressive treatment of skull base osteomyelitis are crucial for favorable outcomes.
• Tailored antibiotic or symptomatic treatment for AOM based on age and severity optimizes patient care.
• Proactive management of chronic otitis media and prompt evaluation of complicated AOM prevent long-term sequelae.