Prognosis

• acute otitis media is self-limiting illness that will resolve without antibiotics in around three days in 80% of children
• a rupture of the tympanic membrane usually heals
  • study was undertaken to define the characteristics of spontaneous eardrum perforation in acute otitis media (1)
    • in this study 29.5 per cent children with acute otitis media had eardrums which perforated. An increased incidence of perforation was associated with a previous history of otitis media. All perforations were small and limited exclusively to the pars tensa
    • the perforation spontaneously closed in 94 per cent of the patients within one month. The healing process was gradual and following perforation closure, there was evidence of middle ear effusion for some time before normal aeration was regained
• it rare for mastoiditis or a cerebral abscess to occur
• in some children, there may be recurrent acute otitis media or persistent middle ear effusion following an episode of acute otitis media (2)

Reference:

• (1) Berger G. Nature of spontaneous tympanic membrane perforation in acute otitis media in children. J Laryngol Otol. 1989 Dec;103(12):1150-3.
• (2) Damoiseaux RA et al. Long-term prognosis of acute otitis media in infancy: determinants of recurrent acute otitis media and persistent middle ear effusion. Family Practice 2006;23(1):40-45.