OTITIS MEDIA

Acute Otitis Media

Acute Otitis Media

Introduction

Acute Otitis Media (AOM) is defined as an irritation or swelling of the middle ear. It is also known as an infection of middle ear (Cassel, 2003). It is the most often occurring viral & limited to a single person; it is a usual associated viral URI know as Upper Respiratory Infection. This virus generally occurs among children aged less than ten years. Another term Otitis Media with effusion (OME), which is also defined as irritation or swelling of the middle ear, is the accumulation of fluid in the middle ear cleft with no signs & indication of acute irritation (Paradise et al, 1997). This is commonly referred as a glue ear.

Recently updated systematic review on antibiotic treatment of CCA in children Cochrane Collaboration review, updated in November 2008, reported that antibiotics seem to be more useful (as compared to older age) in children aged up to two years with bilateral AOM & children with CCA & otorrhea. Perhaps, it is wiser to accept the results of this study as a reference when deciding whether to prescribe antibiotics for children with AOM.

Classification based on evidence statements

The proofs are based on the application to reproduce the standard of evidences & the stability of benefits & harms that are expected (Roberts & Zeisel, 2000).

Guideline Definitions for Evidence based Statements

Quality of evidence for Grades of Evidence

OME subcommittee does value judgments in order to minimize danger & reduce unnecessary treatment. Importance is being given to the task of promptly identifying & managing children on risky situations (Shekelle & Takata, 2003).

PNEUMATIC OTOSCOPY:

This is an important recommendation on the source of systematic evaluation of studies of cohort & the prevalence of benefit above harm.

Profile of Evidence: Pneumatic Otoscopy

Collective quality of evidence: An analytic study in an applicable & relevant population,

Benefits: better diagnostic accurateness and low-cost equipments,

Harms: cost of training of clinicians in pneumatic otoscopy,

Benefits & harms evaluation: prevalence of benefits above harms,

Level of Policy: strong recommendations.

TYMPANOMETRY:

This alternative is presented on the basis of studies of cohort & equilibrium of benefits & harms. Diagnosing and analyzing OME correctly is essential for appropriate supervision. Furthermore, OME must be distinguished from AOM to avoid needless anti-microbial usage.

The evidence report of AHRQ systematically analyzed the sensitivity level, specificity level, & predictive values of 9 diagnostic techniques for OME. Pneumatic otoscopy had the finest equilibrium of responsiveness & preciseness, reliable with the guidelines. Pneumatic otoscopy consequently should continue as the primary method of OME diagnosis, because the device is cost efficient & perfect (Stool et al, 1994).

Profile of Evidence: Tympanometry

Collective quality of evidence: analytic studies with little restrictions,

Benefits: increased diagnostic accurateness,

Harms: cost of acquisition, managerial load,

Benefits & harms evaluation: stability of benefits & harms,

Level of Policy: alternatives.

SCREENING: POPULATION BASED TESTING PROGRAMS

This suggestion is made on the basis of randomly generated controlled trials & studies of cohort, in association of predominance of harms over advantage. This recommendation is concerned about population based test programs of all children without considering any ...