A 34-year-old female presents to the emergency department complaining of left ear pain. She reports that the discomfort began a day ago. She had previously had mild viral symptoms including congestion, headache, and malaise. She reports a sensation of fullness in her left ear along with decreased hearing. This image of her left tympanic membrane is obtained.
The patient has mild acute otitis media (AOM).
The AOM in this case is involving only the pars flaccida of the tympanic membrane. The pars tensa and the malleus are still discernable. This would generally be considered early and mild AOM. Given the clear presence of bulging of the tympanic membrane along with discomfort, a course of oral antibiotics would be reasonable.
Compare these three different cases of acute otitis media (AOM) ranging from mild to severe. With each increasing level of severity, more of the normal anatomy of the tympanic membrane is lost. For example, in the case of severe AOM, the malleus is no longer discernable due to the distension of the tympanic membrane.