Acute Otitis Media and Complications
Last Academic Update: May 3, 2026
Overview
A practical emergency approach for the ENT physician assessing a patient with ear pain, fever, a bulging tympanic membrane, or otorrhea. The aim is clear: do not confuse uncomplicated AOM, which may need analgesia, observation, and sometimes oral antibiotics, with complicated AOM that has started to break out of the middle ear into the mastoid, labyrinth, facial nerve canal, petrous apex, venous sinuses, or intracranial space. On call, the diagnosis is not simply “ear infection.” The real question is: is the pus still contained in the middle ear, or has it started crossing anatomical borders?
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