Otitis media nosology

Among otitis media defined as the inflammation of the tympanic cavity, the annexial cavities and the Eustachian tube, it is interesting to individualize otitis media with effusion in children. These include five clinically identifiable entities: acute otitis media, unresponsive acute otitis media, otitis media with residual effusion, otitis media with persistent effusion, and recurrent acute otitis media. Acute otitis media presents with systemic and local signs and has generally a rapid onset; a residual effusion, which can persist a few weeks, defines the otitis media with residual effusion. The persistence of this effusion beyond 3 months without signs of infection defines otitis media with persistent effusion. Sometimes, acute otitis media is persistant beyond 3 weeks and could be favoured by a previous effusion. Recurrent acute otitis media is defined by the occurrence of 3 episodes of acute otitis media in less than 3 months. This notion of otitis media with effusion is important because it focuses on the existing continuum between different forms of otitis media which can conduct to severe chronic otitis media. It can also be considered as a temporary diagnosis when the clinical signs, the evolution and the history are missing.