Therefore, children generally have functional improvement with age. Other factors that contribute to Eustachian tube dysfunction are allergies and seasonal changes. Two common agents that have been identified are Strep. Lab Findings Lab tests are usually not necessary in the diagnosis of acute otitis media. Imaging Findings Computed tomography may be indicated when it is suspected the child has a suppurative complication such as mastoiditis or cavernous sinus thrombosis.
Pathology See Pathophysiology above.
The first line of defense is antimicrobial therapy, such as amoxicillin or ampicillin. The treatment of recurrent acute otitis media is initially the same as acute otitis media, but may be followed by chemoprophylaxis, myringotomy with tympanostomy, or adenoidectomy with or without tonsillectomy. Otolaryngology should be consulted when the physician is uncertain about the appearance of the tympanic membrane by otoscopic examination and otomicroscopic examination is desired, or if the patient has a congenital condition associated with abnormal ear canals, such as Down syndrome or cleft palate. Pressure equalizing tubes placed surgically in the tympanic membrane may be helpful for children with recurrent acute otitis media. Perforation of the tympanic membrane due to increased pressure from the purulent material in the middle ear.