A 6-year-old child presents to the pediatric clinic with several days of cough, throat pain, and now 12 hours of right ear pain. On exam, the child appears ill without being toxic, has rhinorrhea, a fever of 101.5F, and clear lungs. The above image of the right ear is obtained.
The child has acute otitis media (AOM). The hallmark of AOM is a bulging eardrum which often appears as an “angry doughnut.” The reason for the bulging is an infection that increases the pressure in the middle ear space which is behind the eardrum. It looks uncomfortable, and it is. Treatment includes pain control with ibuprofen or acetaminophen. Generally, antibiotics would also be prescribed. Children are more susceptible than adults to otitis media because their eustachian tubes are more horizontal. If the child has recurrent otitis media, ventilation tubes will often be placed.
Understanding normal ear anatomy is helpful to appreciate when something is abnormal. WiscMed has created a short video that explains normal ear anatomy and function.