Acute Otitis Media: Otoscopy

Inflammation of the tympanic membrane can result in a variety of appearances with a range of different colors; alterations in translucency, position, and mobility; and other features such as air bullae, fluid levels, and perforations. Otoscopy typically reveals a bulging, erythemic or cloudy, and immobile tympanic membrane. It is important to remember that tympanic membrane injection (i.e., erythema) can occur due to a variety of causes (e.g., high fever, crying, irritation) and by itself is not diagnostic of an infection. However, intense redness or a clear difference in redness between the two ears is supportive of the diagnosis. Opacity also lacks specificity as it can also be seen in otitis media with effusion. Now, if the tympanic membrane has ruptured, there may be purulence in the ear canal. If pus or cerumen is blocking the view of the tympanic membrane then it should be removed, but NOT via rinsing with a syringe. In addition to above findings, immobility as demonstrated via pneumatic otoscopy can provide evidence of a middle ear effusion. This can be particularly helpful in cases where the tympanic membrane is in a neutral position and yet appears to be inflamed.

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Disclaimer: All the information provided by Medical Education for Visual Learners and associated videos are strictly for informational purposes only. It is not intended as a substitute for medical advice from your health care provider or physician. It should not be used to overrule the advice of a qualified healthcare provider, nor to provide advice for emergency medical treatment. If you think that you or someone that you know may be suffering from a medical condition, then please consult your physician or seek immediate medical attention.

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