Date of Degree

5-2015

Document Type

Capstone Project

Degree Name

Au.D.

Program

Audiology

Advisor(s)

Shlomo Silman

Michele B. Emmer

Subject Categories

Speech Pathology and Audiology

Abstract

Otitis media is an inflammatory pathology of the middle ear and middle ear mucosa which accounts for the majority of cases of childhood hearing loss diagnosed by audiologists. However, considerable confusion exists regarding the distinction between otitis media with effusion, also known as middle ear effusion or “glue ear”, and acute otitis media, the quintessential ear infection. Since many children are referred for audiological evaluation in the process of determining the course of treatment and outcomes of treatment, audiologists must be knowledgeable of the evidence of efficacy for various treatment options as they field questions from parents with incomplete information from their physicians. Systematic reviews and guidelines for management of otitis media have been published repeatedly, but Berkman et. al (2013) contend that uncertainty remains among physicians regarding the comparative benefits and costs of the various treatment strategies, due to the lack of consensus on clinical and long-term functional outcomes of otitis media with effusion. The aim of this review is to present otitis media with effusion versus acute otitis media within the framework of their anatomy and pathophysiology; to address all methods currently used to treat otitis media with effusion and acute otitis media; and to propose a preferred way of treating middle ear effusion. A database search was conducted to identify studies on otitis media and its treatments. Criteria for diagnosis as acute otitis media and otitis media with effusion were clearly established, and the evidence from relevant publications was critically analyzed. A remarkably favorable natural history for otitis media regardless of treatment was found, suggesting that many medical and surgical interventions are preemptively used despite their risks. Implications of this trend for those involved in the treatment and management of children with this pathology are discussed in this review.

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