Contemporary Approach to Recurrent Acute Otitis Media

Background: Otitis media is one of the most common pediatric diseases. Management of recurrent acute otitis media (RAOM) in children is challenging due to poor understanding of middle ear/Eustachian tube patophysiology and low quality of evidence-based practice.

Objective: To define an updated clinical pathway for children affected by RAOM.

Methods: Current guidelines and recent literature have been reviewed.

Results: We come up with a comprehensive algorithm on the management of RAOM including updates on classification, prevention and treatment. Age-dependency, different clinical deatures and frequency of episodes have been implemented. Recent advances on water precautions and effectiveness of topical treatment for otorrhea after ventilation tube placement, ballon dilation of the Eustachian tube and bacteriotherapy have been included.

Conclusion: The algorithm addresses decisions on RAOM management in a broad spectrum of situations, and is also a useful tool for counseling families.