---
title: "Acute Necrotizing Otitis Media"
description: "ENT notes on definition, pathogenesis, clinical features, treatment of Acute Necrotizing Otitis Media."
source: "The ENT Resident"
author: "Dr. Mausumi Das"
canonical_url: "https://www.theentresident.com/ent-notes-lectures/acute-necrotizing-otitis-media"
categories: ["Otology"]
video: "https://www.youtube.com/watch?v=UXl1AtT6Vwk"
image: "https://media.theentresident.com/og-images/acute-necrotizing-otitis-media.png"
---

# Acute Necrotizing Otitis Media

ENT notes on definition, pathogenesis, clinical features, treatment of Acute Necrotizing Otitis Media. Watch the full video lecture on YouTube: https://www.youtube.com/watch?v=UXl1AtT6Vwk

## 🧠 Acute Necrotizing Otitis Media (ANOM)

### 📌 What is Acute Necrotizing Otitis Media?

**Acute Necrotizing Otitis Media (ANOM)** is a **severe, necrotizing variant of Acute Suppurative Otitis Media (ASOM)**. 

It typically affects **infants and children** following certain viral illnesses.

>What viral illnesses cause Acute Necrotizing Otitis Media?

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### 🦠 Causative Organisms of Acute Necrotizing Otitis Media

- **Beta-hemolytic Streptococcus** (most common)
- Viruses that precede bacterial invasion

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### 🔬 Pathogenesis of Acute Necrotizing Otitis Media

- Starts as a typical ASOM but progresses rapidly due to **virulent organisms**.

- Leads to **necrosis or gangrene** of:
  - Soft tissues of the middle ear
  - Sometimes even **bone** (e.g., ossicles, mastoid air cells)

>What is the most vulnerable site in Acute Necrotizing Otitis Media?

>What are the different structures affected in Acute Necrotizing Otitis Media?

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### 🩺 Clinical Features of Acute Necrotizing Otitis Media

- **Profuse, foul-smelling otorrhea**
- **Large or total central perforation** (often kidney-shaped)
- Severe **conductive hearing loss**
- Necrotic tissue visible in ear canal and middle ear
- May follow an upper respiratory or viral illness

---

### 💊 Treatment of Acute Necrotizing Otitis Media

1. **Antibacterial Therapy**  
   - Start **early**, continue for **7–10 days minimum**
   - Target **beta-hemolytic Streptococcus**

2. **Cortical Mastoidectomy**  
   - Only indicated if:
     - No response to antibiotics
     - Complications like **acute mastoiditis**

---

### 📉 Outcomes of Acute Necrotizing Otitis Media

There are **five possible outcomes**:

1. **Healing with remnant scar** at central perforation site  
2. **Permanent conductive hearing loss** after healing  
3. **Persistent kidney-shaped perforation** with hearing loss  
4. **Persistent perforation** with **chronic mucoid discharge**  
5. **Secondary acquired cholesteatoma** due to squamous epithelial ingrowth from meatus

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>What are the differences between Acute Necrotizing Otitis Media (ANOM) and Acute Suppurative Otitis Media (ASOM)?

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## About This Note

This free ENT note on Acute Necrotizing Otitis Media was written by Dr. Mausumi Das and is paired with a corresponding video lecture.

Canonical page of this note: https://www.theentresident.com/ent-notes-lectures/acute-necrotizing-otitis-media

When citing or referencing this content, please credit The ENT Resident and link to the canonical page above.

## Related Notes by Category

- Otology: https://www.theentresident.com/ent-notes-lectures/category/otology.md

## About The ENT Resident

The ENT Resident is an educational website and resource library created by Dr. Mausumi Das (MS ENT) for ENT residents, ENT postgraduates preparing for exams, and MBBS students.

Dr. Mausumi Das writes the notes, draws the diagrams, and records the lectures herself.

Browse all ENT notes and lectures on The ENT Resident: https://www.theentresident.com/ent-notes-lectures.md

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The ENT Resident provides educational material for medical learning and revision. It does not provide patient-specific medical advice, diagnosis, or emergency care, and it is not a substitute for evaluation by a qualified healthcare professional.

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