Otitis media classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.


Otitis media can be classified into acute, effusive, and chronic suppurative forms. Their clinical presentations will vary based on the different symptoms. The treatment necessity will also vary based on classification.


Otitis media can be divided into 3 subtypes, differentiating in their clinical presentation.

Acute Otitis Media

Otitis Media with Effusion

  • Otitis media with effusion (OME) is non-infectiously caused otitis media based on fluid buildup in the eustachian tube.[3]
  • It is usually caused by irritants, allergies, or upper respiratory infection that does not infect the ear itself.
  • The fluid buildup may remain trapped in the middle ear preceding or following acute otitis media.
  • Symptoms usually include partial hearing loss and feelings of "fullness" in the ear, but do not usually present pain, common cold symptoms, fever, or other indicators of illness that is common in AOM.
  • OME is usually self-limited and does not require treatment to resolve itself.

Chronic Suppurative Otitis Media

  • Chronic suppurative otitis media (CSOM) is usually classified by the persistence of pus discharge due to tympanic perforation from acute otitis media for 6-12 weeks following treatment.[4]
  • The symptoms are similar to those of AOM, but persist due to the resistant active bateria causing suppuration in the ear, heightening the risk of temporary and permanent hearing loss.[5]
  • Treatment is required and will vary due to severity:
  • CSOM can result in otorrhea and can be classified by visible pus discharge outside of the middle ear.


  1. Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M (2014). "Update on otitis media - prevention and treatment". Infect Drug Resist. 7: 15–24. doi:10.2147/IDR.S39637. PMC 3894142. PMID 24453496.
  2. "Ear infection - acute: MedlinePlus Medical Encyclopedia".
  3. "Otitis media with effusion: MedlinePlus Medical Encyclopedia".
  4. "www.who.int" (PDF).
  5. Acuin J (2007). "Chronic suppurative otitis media". BMJ Clin Evid. 2007. PMC 2943814. PMID 19454051.

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