<unk>  is inflammation of the middle ear.<unk>  was first described by Hippocrates in the 5th century B.C.E. Initial therapies for<unk>  were surgical, particularly mastoidectomy, which was first performed by French physician Jean-Louis Petit in the 17th century C.E. Antibiotic therapy for<unk>  treatment emerged with the invention of mass production of penicillin in 1940 by Alexander Fleming, Howard Florey, and Ernst Chain. The pathogenesis of<unk>  is directly connected to the pathogen responsible for nasopharyngitis. This includes infectious causes, such as viral upper respiratory infection, as well as bacterial infection from Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus. Mucus in the middle ear causes congestion that results in dysfunction of the eustachian tube. Pressure regulation in the inner ear is altered, causing effusion of fluid into the tympanic cavity containing the pathogen of nasopharyngitis.<unk>  results from the inflammatory response to the infection.<unk>  is transmitted through respiratory droplets through saliva or mucus, as well as direct physical contact with a contaminated individual or physical surface. There is evidence of genetic predisposition to<unk> , with statistically significant evidence that it has high heritability.<unk>  can be classified into acute, effusive, and chronic suppurative forms. Their clinical presentations will vary based on the different symptoms. The most common symptoms of all classifications of<unk>  are ear pain and feelings of "fullness" in the ear due to fluid buildup in the eustachian tube. These are usually accompanied by ear fluid discharge, as well as partial loss of hearing. Common cold symptoms, including cough, nasal discharge, and fever, usually accompany acute<unk> . Symptoms of chronic<unk>  with effusion usually include neurological conditions, such as irritability, poor physical coordination, and delayed speech development and poor attention span in infants and young children. Upon physical examination, the most indicative signs of<unk>  by otoscopic examination of the middle ear include erythema, bulging, cloud appearance, and immobility of the tympanic membrane. The presence of effusion is also indicative of<unk> . The mainstay of therapy for acute<unk>  (AOM) is antimicrobial therapy. Ear pain is managed with acetaminophen, ibuprofen, or narcotic analgesics with codeine. Surgery to treat<unk>  is primarily myringotomy with or without insertion of a tympanostomy tube. It is indicated for recurrent cases of acute<unk>  and chronic suppurative<unk>  when non-surgical treatment therapies do not relieve symptoms. Preventing<unk>  primarily involves preventing developing nasopharyngitis. Preventing exposure to air pollution as potential middle ear irritants, such as secondhand smoke, contributes to preventing<unk> . For infants, preventative measures include avoiding pacifiers, avoiding daycare enrollment, and breastfeeding until at least 6 months of age.<unk>  must be differentiated from other diseases that cause ear pain or ear itchiness, hearing loss, middle ear discharge, tympanic effusion, and dizziness. The most potent risk factor for<unk>  is age, specifically being younger than 5 years old. Other common risk factors include exposure to smoke and air pollution, malnutrition, lack of breastfeeding, enrollment in daycare, allergies or recurrent upper respiratory infections, living in cold climates or climates subject to sudden changes, being a male younger than 20 months old, and being of Caucasian, Greenlandic, Southeast Asian, or Sub-Saharan West African descent. The incidence for<unk>  is usually high: on an annual basis, approximately 10% of the world's population will develop acute<unk>  (AOM). Children under 5 years old are the primary demographic for<unk> : 51% of the global incidence of AOM and 22.6% of the global incidence of CSOM are under 5 years old. The prognosis of<unk>  is usually good with or without treatment, but varies based on the classification. Acute<unk>  is self-limited and usually resolves itself within 14 days, and<unk>  with effusion will usually resolve itself within 3-6 months. Chronic suppurative<unk>  will usually require surgical or antibiotic intervention to alleviate symptoms and resolve the disease. Complications of<unk>  result from the spread of causative infection, as well as damage to the tympanic membrane due to fluid buildup and pressure changes. Presence of complications can increase the morbidity in<unk>  patients and decrease the prognosis.
Otitis media
Strep throat
Otitis externa
Rhinosinusitis
Mastoiditis
Typhlitis
Rhinitis
Chondritis