By A/P Henry Tan and Dr Eng Soh Ping

What is otitis media?

Otitis media (OM) includes a range of potentially serious inflammatory middle ear infections which commonly occur in childhood¹. OM is classified into distinct categories according to their symptoms, severity and duration.

• Acute otitis media (AOM) - generally defined as the presence of middle ear effusion (fluid) accompanied with the rapid onset of one or more signs or symptoms of inflammation in the middle ear, such as ear pain / earache, discharge from the ear, fever and irritability¹
• OM with effusion (OME) - involves fluid behind an intact eardrum without signs or symptoms of infection²
• Recurrent (ROM) - defined as three or more episodes of AOM during 12 months²
• Chronic OM (COM) - defined as the occurrence of more than six episodes of AOM in 12 months
• Chronic OM with effusion (COME) - OME is defined as chronic when middle ear effusion has been present for at least three months²
• Chronic suppurative OM (CSOM) - defined as a chronic inflammation of the middle ear in which a perforated eardrum and discharge are present¹

How common is OM?

OM is one of the most frequent diseases of childhood. By the age of three years, it is estimated that three quarters of all children will have had at least one episode of OM and more than one third will have had repeated infections (defined as three or more episodes in one year).³

The peak incidence of acute otitis media is among children aged 6-18 months. The age at which the first episode occurs is associated with the child experiencing repeated episodes i.e. the earlier the first episode occurs, the more likely it is to recur.³

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