Talk:Otitis media/Archive 1

Homeopathy
The homeopathy section is excessive and cites a homeopathy journal article for support. Homeopathy journals are about the only place you'll find any support for these unscientific methods - they are universally ridiculed by scientific medicine. The concept that a medicine's effectiveness varies in inverse proportion to the amount administered would be comical if it weren't an actual belief. It is like citing an alchemy journal which purports to change base metal into gold, rather than talking to a chemist. To be sure there is spirited debate regarding the treatment of OM, which is all to the good, but homeopathy - while it should be mentioned - offers nothing of scientific merit to this article. Rmcnabb 15:10, 25 February 2007 (UTC)rmcnabbRmcnabb 15:10, 25 February 2007 (UTC)


 * i cited 4 articles for support, one of which is a homeopathy journal, and two of which are conventional, peer-reviewed journals - Pediatr Infect Dis J & Int J Clin Pharmacol Ther. Ignore the others if you prefer, that is your choice, but please allow other people to make their own informed decision. 82.35.25.19 18:24, 10 March 2007 (UTC) cazldn


 * I've deleted the passage on Homeopathy in accordance with WP:Reliable Sources. The cited articles are themselves at best flawed and at most outright fallacious.  (Cum hoc ergo propter hoc)  Unless someone can provide some exceptional sources to support this exceptional claim, I recommend it stay deleted.  Swakeman 02:25, 14 March 2007 (UTC)


 * Please justify your claim that The Pediatric Infectious Disease Journal and The International Journal of Clinical Pharmacology and Therapeutics are unreliable sources.


 * Further, could you please point out exactly which aspects of the studies are flawed and fallacious so that I may respond to them specifically.
 * cazldn 82.45.189.76 16:59, 19 March 2007 (UTC)


 * This is a claim which is not supported by the mainstream scientific community, and therefore requires more profound sourcing than that homeopathic treatments subjectively reduce pain. For example, your abstract for "Acute otitis media in children," it merely states that homeopathic treatment results in subjectively more pain relief than conventional treatment.  This does not mean that homeopathic treatment is more efficient in the treatment of otitis media, but rather that homeopathic treatment is more efficient in the treatment of pain than the conventional treatment for otitis media.  Morphine, for example, may produce a much greater reduction of pain, but that doesn't make it a miracle cure for acute otitis media.  Swakeman 22:56, 26 March 2007 (UTC)


 * I think I did give you 'more profound sourcing' than hom. subjectively reduces pain. The 'Acute O.M in children' article to which you refer also showed faster resolution rates and fewer complications in the homeopathically treated group than the conventional group.


 * The Friese study showed that 70% of children did not have another ear infection for a year following homeopathic treament cf. 56% in the conventionally treated group.  26% of the hom group had a maximum of 3 infections in the following year cf. 43% of the conv. group had a maximum of 6 infections in the next year.


 * If you can point to anything 'flawed' or 'fallacious' in this study I'll do my best to respond. cazldn 82.35.240.22 16:42, 29 March 2007 (UTC)


 * The former example actually illustrates my point quite perfectly. I myself have absolutely no clue what it means for a treatment to exhibit resolution rates "2.4 times faster than placebo controls."  Absolute rubbish.  A resolution rate can be greater or less than, but can't be faster.  That also refers to placebo controls, making no statement concerning treatment effectiveness relative to conventional treatment.  Also, you wrote that the homeopathic group showed fewer complications than the conventional group... however the study only states that no complications were observed in the homeopathic study.


 * The Jacobs study first admits outright that the study is not statistically significant. The study only states that homeopathy experienced less treatment failures compared to placebo and makes no mention of any conventional treatment.


 * The Harrison study is a "pilot" and includes only 33 participants.


 * That leaves only the Friese study which isn't glaringly fallacious at first glance. One study, however, is hardly enough to convince me.  Swakeman 01:59, 30 March 2007 (UTC)

The article was left with no mention of the available "alternative" therapies, so I mentioned a few, all from one book ref. There are tons more sources, so let's don't leave this out, whether you're personally convinced or not. Pick better sources if you like. Dicklyon (talk) 06:53, 2 March 2008 (UTC)

Valsalva maneuver?
Is is true that "repeated use of the Valsalva maneuver to dislodge infected matter from the middle ear can cause this matter to enter the eye cavity, leading to conjunctivitis." This may be true, but it sounds a bit bizarre to the casual reader so a citation would be useful. Manuz 04:03, 10 January 2007 (UTC)

I am a medical student and have never heard of this before. Could we please have a reference? Nikola Lilic Jnr. (talk) 00:41, 24 October 2008 (UTC)

This is not true, and it appears to have been removed already. Sorry for my late response. =) justin.kirkham (talk) 12:36, 20 April 2010 (UTC)

Conventional Treatment
while plugging our favorite brands on wiki, we should at least try to use good sentence structure and not that of a common marketer. A good treatment is Using Eardoc is the best non invasive treatment today it generates and transmits vibration waves through the bone and the ear base to the middle ear and the Eustachian tube. 66.55.213.235 04:15, 9 February 2007 (UTC)

How about adding references to
Good page. How about adding link / reference to Myringotomy information? 66.26.88.42 16:06, 24 February 2007 (UTC)

How about adding references to the EARDOC
This is the only non invasive device there is in the market and it opens the Eustachian tube! people should know about it! —Preceding unsigned comment added by 77.126.125.27 (talk • contribs) 20:05, 14 June 2008

why are the link references are being deleted ? —Preceding unsigned comment added by 77.127.93.150 (talk • contribs) 17:48, 21 June 2008


 * Eardoc device has been repeatedly spammed across multiple ear topics. Despite repeated warnings to the spamming (now indefinitely blocked) registered user and anon IPs, the spamming continued and as per spam warnings given, has resulted in the eardoc site now being blacklisted entirely. see blocklog,,  and blacklist log
 * That all said, a quick dnsstuff check shows 84.108.199.3, 77.127.161.173, 77.126.125.27, 77.127.93.150 all originate from same place - leads to conclusion solitary spammer or at least Meatpuppets... but since engaging in discussion finally started, lets consider:
 * To move on from the spamming issues, might there be some worthy information to note about the device ? Who knows - citing a company's own marketing claims is not using WP:reliable sources (i.e. third-party independant sources). Adding mention of this device needs two levels of evidence:
 * That it has notable usage (irrespective of whether one thinks it works or not) . Hence some independant source to verify market sales or some official body of otolaryngologists recomending it.
 * To make any claim that it actually works, needs referencing to a reliable source (i.e. certainly not the company which has a COI) in order to WP:Verify. Yet PubMed's 17 million citations contain exactly zero references to "eardoc". David Ruben Talk 00:41, 22 June 2008 (UTC)

otitis media with effusion
Otitis media with effusion is a recognised cause of auditory processing disoder, and as such is also recognised as an underlying cause of dyalexia. Therefore otitis media does belong in the dyslexia category as one of medical problems which cause the neurologicla issues that can cause dyslexia.

dolfrog (talk) 14:02, 18 June 2009 (UTC)
 * See discussion and consensus at Wikipedia talk:WikiProject Dyslexia. Gordonofcartoon (talk) 14:11, 18 June 2009 (UTC)


 * Okay, dolfrog. That's all well and good. But the article doesn't mention anything about that. In fact, the only place the word "dyslexia" appeared at all was in the category list. Adding a seemingly off-topic category to an article that seems to have nothing to do with that category without any discussion on the talk page tends to get reverted.


 * If you want to place this article into the dyslexia category, then you probably need to add what you're saying to the article. In order to add it to the article, you need to provide reliable sources that back up your claims (I'd look at the guidelines for reliable sources for medical articles as well). If you can suggest good text, and provide solid medical references for what you're saying (such as studies and reviews published in peer-reviewed journals), then we can likely add this to the article. If the addition warrants the category (we won't know that until we see the addition), then we can add the category.


 * I'd suggest that you place draft text here on the talk page for discussion (though you are by no means obligated to do so, it might help to avoid multiple reverts if you built consensus first). If the text is on point and well sourced, I'll back it for inclusion (for my part). Keep in mind, though, that it may or may not make sense to add the category even if we add some verbiage to the article. As I said, we'll have to cross that bridge when we come to it. Make sense? -- Transity  ( talk &bull; contribs ) 14:27, 18 June 2009 (UTC)
 * Looks good. The category is fine if the page substantially mentions it (up to WP:MEDRS standard, obviously). Gordonofcartoon (talk) 15:07, 18 June 2009 (UTC)

Otitis media with effusion belongs in the dyslexia category
In the UK is accepted having suffered from Otitis media with effusion (glue Ear) can lead to dyslexia in later years, and that coping with prolonged periods of Otitis media with effusion can change the neurological paths ways as to cause an Auditory Processing Disorder. The UK Medical Research Council states in its Auditory Processing Disorder booklet that Otitis media with effusion is a cause of Auditory Processing Disorder, so they must have the research to support this. I need be I can asked them for more details of the supporting research. dolfrog (talk) 11:49, 8 July 2009 (UTC)

And what does RR2 mean. More indeciferable WIKI jargon dolfrog (talk) 12:03, 8 July 2009 (UTC)
 * As discussed, the category belongs only if the article substantially mentions the connection.
 * "RR" = second revert. Three reverts: baaaad. Gordonofcartoon (talk) 12:41, 8 July 2009 (UTC)

Well I not going to get into an editing war or revert war, but the UK dyslexia is seen as a side effect of having Otitis media with effusion. And I assumed that the editors of this article would have already include this information before I arrived on the scene. This in nothing new in the UK, and is understood by consensus to use your term. So this more about this editors of this article catching up with years old research.dolfrog (talk) 12:54, 8 July 2009 (UTC)


 * You still haven't shown us the research that backs up your claims. Saying that the editors just need to "catch up" with years old research isn't helpful. We cannot be aware in advance of every piece of information on a given topic (let alone multiple topics). If you have reliable sources to backup the claims you are making, then you need to present them here so that we can review them. If you don't have such sources, then you need to find them. If you can't find them, then it's doubtful that you will gain consensus to add your claims to the article. As a note, I followed your link to the APD booklet above, but at a glance I didn't see any information pertinent to this discussion. If it's there, point it out with a direct link, please. Note, though, that if the information is there, it still may or may not qualify as a reliable source for a medical article. -- Transity  ( talk &bull; contribs ) 14:41, 8 July 2009 (UTC)

The APD booklet was produce the the UK funded Medical Research Councils Institute of Hearing Research in 2004 as a guide to APD for all, but they only state what they can support with research evidence From the booklet in the section entitle causes of APD. "APD may also be caused by long term middle ear disease (‘glue ear’) or by limited access to communication. In rare cases, injuries to the head may cause APD." Glue Ear is what we call Otitis Media with effusion outside of research circles in the UK. You contact the Institute of Hearing Research and they could guide you to the supportive research documentation. dolfrog (talk) 15:25, 8 July 2009 (UTC)


 * I think you're missing the point here. Telling me to contact this group to find the relevant research studies doesn't get the job done. If these studies exist, and they have been published in reputable, peer-reviewed journals, then you should be able to locate them (perhaps in PubMed). As it stands, you still haven't provided any resources to backup your claims, and as such, there is no valid argument for including them in the article.


 * For the record, I went to the booklet, and read the "Causes" section. In short, it says that they don't know much about what causes this disorder, but that "glue ear" and other things that cause limited hearing "may" be causes of APD. That's the strongest statement that they make, as far as I can see. There are no reviews or studies listed anywhere in this booklet (that I have seen), and their sources for more information say about the same as the booklet (some don't even mention ear disorders of any kind, and none seem to point out any actual studies).


 * As it stands right now, you might gain consensus to add a brief mention in the section about OME - something like: "Further research is needed to determine if prolonged OME may lead to an Auditory Processing Disorder." with the booklet as a reference. That certainly wouldn't be enough to include the dyslexia category on the article in my opinion. -- Transity  ( talk &bull; contribs ) 18:55, 8 July 2009 (UTC)

The UK Medical Research Council only published peer reviewed research, peer reviewed research is the only type of research that would be supported by UK government funding. Not all UK peer reviewed research is accessable via PubMED, the same applies to research from other countries as well, as I have found out doing the research into dyslexia which is not my own area of specilisation. As I said the Institute of Hearing Research, which is the Auditory branch of the UK Medical Research Council would be able provide information as to which journals published the relavent peer reviewed research. The Medical Research Council defines all medical conditions for the UK. So if you do as i suggested and ask them to provide the links to the peer reviewed research both before and after 20004 this may help you up date your article. The booklet was published as an opening position statement based on existing research before any APD research was carried out in the UK since then there has been 5 years of intensive APD research in the UK co-ordinated by the Medical Research Council and the multi-discipline UK APD steering Committee. When i have finished contributing o the dyslexia article and begin researching to edit the Auditory Processing Disorder article, I will contact this article again and may be able to provide more detail, but i can only do one thing at a time, multi tasking is not my strong point. dolfrog (talk) 21:37, 8 July 2009 (UTC)


 * In my opinion, the article is fine as it is, without mention of a speculative link between OME and APD. I'm sure this will wait until you have the time to research it properly. Until then, it's pretty clear that this article doesn't belong in the dyslexia category, so let's close out this discussion until the research is made available. Good luck. -- Transity  ( talk &bull; contribs ) 22:43, 8 July 2009 (UTC)

Otitis Media Research Paper Collection
Some months back I was having a discussion about Otitis Media with Effusion (OME), Auditory Processing Disorder (APD), and Dyslexia

Since then I have been collating a wide range of Research paper collection, mainly online at PubMed. This includes an Otitis media collection which can be accessed via my online Delicious bookmarking account or User:Dolfrog best wishes dolfrog (talk) 15:58, 7 November 2009 (UTC)

Galbreath technique removed and restored
I restored the Galbreath technique, which is cited to three peer-reviewed journal articles. This was removed a few months ago by WLU, but his removal seems to reflect a misunderstanding of evidence when it comes to certain interventions. Not every intervention can be tested with a placebo control, and no evidence has been presented that the studies are "poor quality". II | (t - c) 18:33, 14 July 2010 (UTC)


 * First of all we are not to use primary research to refute secondary reviews per WP:MEDMOS


 * This ref does not mention otitis thus its use to claim safety of this treatment for otitis is WP:OR "A 2006 review of 346 people found no complications with pediatric osteopathic treatments. "


 * This ref is a case study "There is a manipulation technique that can be done at home for improving drainage was described in a 2000 article. " but have left it while I look at things further. Doc James (talk · contribs · email) 22:33, 15 December 2010 (UTC)


 * First of all, we're not robots which blindly follow rules. We're humans, and the bureaucratic approach to Wikipedia is widely discouraged (see WP:BURO). Second, Wikipedia is not a clinical guideline. It is a repository of knowledge. Treatments do not need to be definitively proven before being documented. There's no review saying that the Galbreath technique doesn't work, so adding a positive RCT hardly contradicts anything. Anyway, if a review contradicts an RCT with no evidence or explanation, it would be pretty odd to say that RCT is incorrect, wouldn't it? I admit that the 2006 article is not as targeted as I'd thought, but it does mention otitis media as the most commonly diagnosed condition (see table 1).


 * On a somewhat personal note, it is disappointing to note that a very promising RCT was published in 2003, and here we are 7 years later with no replication. Meanwhile, otitis media is widely treated with antibiotics which are becomingly increasingly resistant and have their own issues. Further, you are here trying to suppress the research by deleting mention of an RCT - and meanwhile leaving the entirely unreferenced section about tubes right next to it alone . I know you think you're just following the rules, but I don't see it as helping. The good news is that the results of a second trial will hopefully be coming out soon. II  | (t - c) 00:33, 16 December 2010 (UTC)


 * We should be trying to reflect mainstream scientific opinion. We have hundreds of review articles on otitis media from mainstream journals such as American Family Physician and Cochrane. I have added a number of them to this article. I only expect you to use review articles such as I have. I agree that this article needs work and hope we both will find further review articles to improve it.


 * BTW as you note above I am not the only one who has questioned the significance of the osteopathy research. Doc James (talk · contribs · email) 00:41, 16 December 2010 (UTC)


 * I can't even read most of the Cochrane articles beyond the abstract, so I certainly won't be adding many of them. There's nothing magical about Cochrane. "Mainstream" medicine is not monotholic. As you note, there are hundreds of articles, many with widely varying opinions, and I'll be adding the information that I think is important, relevant, and hopefully accurate. Nor do I accept the absurd idea that the most important determination in a source's reliability is whether it is a review or a research article. Based on that reasoning, one could add that a treatment is promising if a review says it is (based on something like epidemiology), but at the same time one could not add an RCT which, for whatever reason, hasn't been picked up and mentioned by a review. Many reviews add hardly any value to the analysis of these "primary" articles. I do think some review articles are generally preferable for the fundamentals and the broad details, although the quality varies widely. The major benefit of using a review with very little value-added (such as the 2010 review which mentions the Galbreath technique) is that citing reviews reduces ref overload. But when there's only 1 RCT, there's no ref overload. As far as WLU's comments, I was hoping he would flesh them out but he never did. II  | (t - c) 01:10, 16 December 2010 (UTC)


 * Your view is not one held by the majority of people at WP:MED and I guess we will agree to disagree. Cheers Doc James  (talk · contribs · email) 01:14, 16 December 2010 (UTC)


 * Indeed, there were only a few people (User:Paul gene and myself the only ones I remember) who thought that MEDRS had a somewhat confused focus on reviews. By the way, would you agree that if this were an encyclopedia of scholars rather than laymen, it would probably instead focus on research articles rather than review articles to engage directly with the scientific facts? II  | (t - c) 01:18, 16 December 2010 (UTC)


 * There has been discussion over at meta about creating a source such as this ( one that is composed directly of data ). If this where a source created for researchers yes more emphasis would be on primary data. But as it stand we let the researchers interpret the data and use there conclusions.
 * If people started drawing conclusions from single 20 person RCTs with attempts to balance one against another it would be a disaster IMO for a source which allows none researchers to contribute. Doc James  (talk · contribs · email) 01:25, 16 December 2010 (UTC)

Tympanostomy tube indication: Wilson versus McDonald (Cochrane)
Doc, I'm not so sure that these two refs are the same as you say. Wilson specifically says: "The benefit of tubes for recurrent acute otitis media was demonstrated only in studies in which middle-ear effusion was present". McDonald's abstract does not mention effusion at all.

The two reviews appear to include different trials. Wilson includes one trial (Casselbrant et al 1992) which had 264 children. McDonald's abstract says the review included a total of 148 children. Can you look at what McDonald says about Casselbrant? I don't have access to the full-text. NOTE: I just noticed that McDonald says "suppurative" otitis media. However, the article is not currently reflecting this distinction. II | (t - c) 01:36, 16 December 2010 (UTC)


 * Both studies agree that there are benefits from tubes for certain patient groups. Doc James (talk · contribs · email) 01:51, 16 December 2010 (UTC)

Review
A few recent review I plan to incorporate. Feel free to join in... Doc James (talk · contribs · email) 02:54, 16 December 2010 (UTC)
 * Leibovitz et al. 2010 is
 * Ramakrishnan et al. is, free fulltext here.

See also these possibles:
 * LeadSongDog come howl!  18:43, 17 March 2011 (UTC)
 * LeadSongDog come howl!  18:43, 17 March 2011 (UTC)
 * LeadSongDog come howl!  18:43, 17 March 2011 (UTC)

NEJM
New trials in the NEJM. Doc James (talk · contribs · email) 14:24, 13 January 2011 (UTC)
 * 1) http://www.nejm.org/doi/full/10.1056/NEJMe1009121
 * 2) http://www.nejm.org/doi/full/10.1056/NEJMoa1007174
 * 3) http://www.nejm.org/doi/full/10.1056/NEJMoa0912254
 * Well, the first one is an editorial, not a trial. Not sure that's really a secondary source in the MEDRS sense. The others are primary, but no doubt will eventually be reviewed. LeadSongDog come howl!  18:20, 17 March 2011 (UTC)
 * I was referring to the ones in the section above. These are just some papers that got a lot of press which I am sure will eventually be reflected in secondary sources. Doc James  (talk · contribs · email) 18:40, 17 March 2011 (UTC)
 * Just listened to a fascinating review of the NEJM paper. Supposedly there are some issues with the statistics. Reconfirms the importance of waiting for review articles rather than going with primary research. The issue was the in the trial registry there was one primary outcomes and than secondary outcomes while in the final paper all of a sudden there are 4 primary outcomes ( and the original primary outcome was not significant ). The primary harm however was.-- Doc James (talk · contribs · email) 02:12, 26 May 2011 (UTC)

Benefits of amplification
Research shows that the intermittently attenuated access to auditory input and speech caused by recurring incidents of otitis media in young children may have long-term effects on communication, language development, auditory processing, psychosocial and cognitive development. Access to amplification during incidents of otitis media induced hearing loss is of critical importance. In patients with chronic otitis media, the resulting hearing loss often requires life long lifetime commitment.

While recurrent ear infections and discharges may cause discomfort for the patient, the use of air-conduction hearing aids proves difficult or even impossible.

In cases of chronic otitis media, bone anchored hearing aids (BAHA) provides multiple advantages:
 * Baha never obstructs the ear canal. The infection is not aggravated and recurrent ear discharges dry properly. Studies have shown a reduction of ear discharges in patients using a Baha.
 * As early amplification is of utmost importance for children with recurrent otitis media, the BAHAideally facilitates normal language development, and may be used successfully to overcome periods of hearing loss caused by otitis media.
 * The reduction in the number of recurring infections in chronic otitis media patients using Baha provides a cost-efficient solution.
 * In a comparison of subgroups, patients with chronic otitis media had one of the highest levels of satisfaction with Baha, indicating substantial benefits both generally, socially and physically.

Children with recurrent otitis media should have their hearing monitored closely and when a hearing loss is discovered, amplification should be provided without delay. Baha offers several benefits for this patient group and should be considered as a beneficial treatment option for intermittent and chronic cases of hearing loss during childhood.

Missed this here until it can be discussed. It is a little too promotional. Doc James (talk · contribs · email) 16:31, 13 May 2011 (UTC)

2011 review
Doc James (talk · contribs · email) 05:26, 9 December 2011 (UTC)

New research suggests that vibration against the mastoid bone behind the affected ear is successful
No citation for this. Failing this, should be removed. Mdscottis (talk) 01:07, 29 September 2012 (UTC)

No citations in National Library of Medicine Mdscottis (talk) 01:11, 29 September 2012 (UTC)

I agree. The statement "If alternative medicine or therapy is not recommended then this will prevent new experimentation that could lead to a scientifically accepted cure" is also heavily biased and misleading at best. — Preceding unsigned comment added by 66.56.61.108 (talk) 00:57, 31 December 2012 (UTC)

Antibiotics>> newer evidence
Have deleted the sentences citing primary studies evaluating the use of antibiotics and updated it with evidence from a Systematic review. Please verify if appropriate. Manu Mathew (talk) 07:19, 19 February 2013 (UTC)

Is nasal aspiration helpful in preventing or reducing ear infections in infants?
Hi, there is no mention of nasal aspiration to reduce the congestion and bacteria that can keep getting into the infants eustachian tubes. Is it good or bad to do nasal aspiration on your infant when they have a blocked nose to try to prevent constant ear infections? Philiashasspots (talk) 12:49, 2 April 2013 (UTC)
 * Well, we can't tell. As far as I know, there's no reliable study about this disgusting method... I'd be skeptical about it, though. The congestion causing the Eustachian tube's blockage is located in the nasopharynx, not the nose itself. And the bacteria definitely won't go away with nasal aspiration - they belong in this part of our body. (Ok, ok, I know: WP:NOTFORUM. Just couldn't resist). Cheers, --Mallexikon (talk) 02:29, 3 April 2013 (UTC)
 * Ok I am aware of WP:NOTFORUM. I am about to make additions to the main article but thought I would discuss the changes first.  In Australia GPs, ENT specialists and chemists recommend using saline drops/sprays and small bulb nasal aspirators to keep the nasal airway clear, including the nasopharynx.  It seems common sense that infants get Otitis media much more than children and adults because infants can't blow their own noses.  The congested mucus and build up of bacteria makes the nasopharynx unhealthy.  The anatomy of the infants Eustachian tube also increases the chance of getting the middle ear infection.  I'd appreciate any editors pointing me to reliable studies that mention this, otherwise I will go looking myself. Philiashasspots (talk) 03:21, 3 April 2013 (UTC)
 * "It seems common sense that infants get Otitis media much more than children and adults because infants can't blow their own noses"... I don't know. Doesn't sound common sense to me. But happy hunting for reliable studies on this. Cheers, --Mallexikon (talk) 06:06, 3 April 2013 (UTC)
 * I just found this journal article . I'll quote the text here and delete if I should not quote text. "Streptococcus pneumoniae is the most frequent cause of otitis media (OM) in children. It has been well documented that nasopharyngeal (NP) colonization is prerequisite for the development of OM. The nasopharynx serves as the reservoir for S. pneumoniae, which enters the middle ear via the eustachian tube from the nasopharynx, particularly during a viral infection. Pneumococci are frequently isolated from the nasopharynxes of healthy individuals, and NP carriage rates of S. pneumoniae are particularly high in children 1 to 2 years of age. Children who are colonized with S. pneumoniae have a higher risk of experiencing episodes of acute OM, and those harboring antibiotic-resistant pneumococci are more likely to have more-frequent episodes of unresolved acute OM." Philiashasspots (talk) 12:10, 3 April 2013 (UTC)
 * Good material! I think in order to include it in the article it is better to paraphrase than to quote, though. Would fit nicely into the "Acute otitis media" subsection. Cheers, --Mallexikon (talk) 12:04, 4 April 2013 (UTC)

Otitis Media with Effusion and Glue Ear
"The fluid in OME is often thin and watery. It used to be thought that the longer the fluid was present, the thicker it became. ("Glue ear" is a common name given to OME with thick fluid.) However, it is now believed that the thickness of the fluid has more to do with the particular ear than with how long the fluid is present." (http://www.nlm.nih.gov/medlineplus/ency/article/007010.htm) — Preceding unsigned comment added by 24.246.135.186 (talk) 06:38, 17 November 2013 (UTC)

Cochrane reviews
Not sure why is from a different Cochrane review group than was. The ENTs and respirologists seem to approach the OM question from rather different directions. Another IDR review at may also be useful. Comments? LeadSongDog come howl!  23:22, 20 February 2014 (UTC)

Reference to Xylitol needed.
Xylitol chewing gu78.30.108.81 (talk) 10:29, 26 July 2014 (UTC)ms, and nasal sprays have been proved helpful in reducing Otitis media - a link, and areference in the section "Prevention" will be helpful
 * Ref needed per WP:MEDRS Doc James  (talk · contribs · email) (if I write on your page reply on mine) 22:19, 26 July 2014 (UTC)

Why is map being removed?
from prognosis? Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:03, 9 August 2014 (UTC)