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Acute Necrotizing Otitis Media

There is rapid destruction of whole of tympanic membrane with its annulus, mucosa of promontory, ossicular chain and even mastoid air cells. There is profuse otorrhea. In these cases, healing is followed by fibrosis or ingrowth of squamous epithelium from the meatus (Secondary acquired cholesteatoma).

  1. Organism: ß hemolytic streptococcus
  2. Age group: Infants, young children
  3. Predisposing factor: Children acutely ill with scarlet fever, measles, pneumonia, influenza
  4. Features: True necrosis and sloughing of the middle ear and adjacent region
  5. Symptoms: Profuse foul smelling otorrhea (cause necrosis of the tympanic mucoperiosteum),                         profourd total sensorineural deafness
  6. Treatment:
    1. i.v. penicillin
    2. i.v. gamma globulin (in fulminant cases)
    3. Cortical mastoidectomy has a equivocal role
    4. Cortical mastoidectomy may be indicated if medical treatment fails to control or the condition gets complicated by acute mastoiditis.​

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