[Acute otitis media with bone conduction hearing loss associated with acute mastoiditis]

Acute otitis media, generally complicated by conductive hearing loss, sometimes shows raised bone conduction thresholds. Five patients with acute otitis media with mixed hearing loss and much otorrhea were reported. The chief complaints were otalgia in 3 patients, hearing loss in 4, ear fullness in 1 and tinnitus in 1. Four patients had moderate hearing loss. At the first examination, the tympanic membrane showed swelling and injection, while 2 showed bullous myringitis, with swelling of the tympanic mucosa and a yellowish serous discharge following myringotomy. Positive mastoidal CT of all patients without acute inflammatory symptoms in the external ear suggest the complication of acute mastoiditis. After treatment with antibiotics and myingotomy for all patients, steroidal administration for 4, and tympanostomy tube insertion for 3, the hearing levels of 4 patients improved. Sensorineural hearing loss (51.3 dB) remains in 1 patient with sever hearing loss at the first examination. It is important to determine the hearing level for patients with acute otitis media, especially if it is complicated by hearing difficulties.