ACUTE OTALGIA IN CHILDREN ‐ FINDINGS AND DIAGNOSIS

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Abstract
Children (171) up to 15 yr of age and with acute otalgia were examined to find out whether otalgia or any other symptoms were so closely related to acute otitis media (AOM) as to make otoscopic examination unnecessary. AOM was diagnosed in 46%, simplex otitis in 15%, serous otitis media (SOM) in 17% and normal eardrums in 22%. Children with AOM had fever and spontaneous perforation of the eardrums in 78 and 30% of the cases, respectively. Of the children who did not have AOM (54%), the otalgia could in most cases, be classified as referred pain due to discomfort when swallowing, nasal obstruction or throat pain. Other reasons were general irritability due to fever, teething or moderate hearing loss. The difficulties in diagnosing AOM simply on the basis of symptoms were demonstrated in the investigation. Symptoms such as otalgia, otorrhea, fever or upper respiratory tract infection (URI), possibly except for the combination of otorrhea and fever, can occur without AOM. A correct otoscopic examination and evaluation of the eardrums is necessary in children with otalgia, other symptoms of URI or in doubtful cases of acute illness. Physicians without possibilities to evaluate the eardrums properly should refer the patient to an otologist without delay.

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