Treatment of Otitis Media

Planning treatment of otitis media requires a stepwise protocol for maximal effect. An organized approach allows the clinician to formulate treatment or change exist­ing treatment based on observations. The steps outlined below provide a framework for treating otitis media.

1. Access middle ear—myringotomy

2. Bacterial culture or cytology (not always helpful)

3. Flush bulla—suction until clean

4. Infuse topical medication into the bulla

5. Reduce inflammation with corticosteroids

6. Systemic antimicrobials

7. Recheck weekly—re-treat two or three times

8. Surgery