ISOM 2023 research Panel 4 - Diagnostics and microbiology of otitis media

Sharon Ovnat Tamir, Seweryn Bialasiewicz, Christopher G. Brennan-Jones, Carolina Der, Liron Kariv, Ian Macharia, Robyn L. Marsh, Amina Seguya, Ruth Thornton

Research output: Contribution to journalReview articlepeer-review

3 Citations (Scopus)


Objectives: To identify and review key research advances from the literature published between 2019 and 2023 on the diagnosis and microbiology of otitis media (OM) including acute otitis media (AOM), recurrent AOM (rAOM), otitis media with effusion (OME), chronic suppurative otitis media (CSOM) and AOM complications (mastoiditis). 

Data sources: PubMed database of the National Library of Medicine. 

Review Methods: All relevant original articles published in Medline in English between July 2019 and February 2023 were identified. Studies that were reviews, case studies, relating to OM complications (other than mastoiditis), and studies focusing on guideline adherence, and consensus statements were excluded. Members of the panel drafted the report based on these search results. 

Main findings: For the diagnosis section, 2294 unique records screened, 55 were eligible for inclusion. For the microbiology section 705 unique records were screened and 137 articles were eligible for inclusion. The main themes that arose in OM diagnosis were the need to incorporate multiple modalities including video-otoscopy, tympanometry, telemedicine and artificial intelligence for accurate diagnoses in all diagnostic settings. Further to this, was the use of new, cheap, readily available tools which may improve access in rural and lowmiddle income (LMIC) settings. For OM aetiology, PCR remains the most sensitive method for detecting middle ear pathogens with microbiome analysis still largely restricted to research use. The global pandemic response reduced rates of OM in children, but post-pandemic shifts should be monitored.

Implication for practice and future research: Cheap, easy to use multi-technique assessments combined with artificial intelligence and/or telemedicine should be integrated into future practice to improve diagnosis and treatment pathways in OM diagnosis. Longitudinal studies investigating the in-vivo process of OM development, timings and in-depth interactions between the triad of bacteria, viruses and the host immune response are still required. Standardized methods of collection and analysis for microbiome studies to enable inter-study comparisons are required. There is a need to target underlying biofilms if going to effectively prevent rAOM and OME and possibly enhance ventilation tube retention.

Original languageEnglish
Article number111741
Pages (from-to)1-13
Number of pages13
JournalInternational Journal of Pediatric Otorhinolaryngology
Publication statusPublished - Nov 2023

Bibliographical note

Funding Information:
R Thornton is supported by a Passe and Williams Foundation Mid-Career Fellowship . She was supported by a Barbara May travel award and a Wesfarmers Centre of Vaccines and Infectious Diseases training award to attend the symposium to present these works. C Brennan-Jones is supported by a Western Australian Department of Health Emerging Leader Fellowship and was supported by the Raine Medical Research Foundation and BrightSpark Foundation to attend the symposium. RL Marsh is supported by an Al and Val Rosenstrauss Fellowship provided by the Rebecca L Cooper Foundation . S Bialasiewicz is supported by the National Health and Medical Research Council grant GNT1181054 . This report was supported by grant R13 DC017389 from the National Institutes of Health , National Institute on Deafness and Other Communication Disorders (to Lauren O. Bakaletz).

Publisher Copyright:
© 2023 Elsevier B.V.


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