Otitis Media

• Otitis media

  Infection in the middle ear
• Middle ear

  • Space between the tympanic membrane (eardrum) and the inner ear
  • Where the cochlea, vestibular apparatus and nerves are found
• How bacteria enter the middle ear

  From the back of the throat through the eustachian tube
• Viral upper respiratory tract infection

  Often precedes bacterial infection of the middle ear
• Common bacterial causes of otitis media

  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Moraxella catarrhalis
  • Staphylococcus aureus
• Streptococcus pneumoniae also commonly causes other ENT infections such as rhino-sinusitis and tonsillitis
• Symptoms of otitis media

  • Ear pain
  • Reduced hearing in the affected ear
  • Feeling generally unwell, for example with fever
  • Symptoms of an upper airway infection such as cough, coryzal symptoms and sore throat
  • Balance issues and vertigo (when the infection affects the vestibular system)
  • Discharge from the ear (when the tympanic membrane has perforated)
• Normal tympanic membrane


  • Pearly-grey, translucent and slightly shiny
  • Malleus visible through the membrane
  • Cone of light reflecting the light of the otoscope
• Tympanic membrane in otitis media

  • Bulging, red, inflamed looking
  • Perforation with discharge in the ear canal