ACUTE SUPPUROUS OTITIS MEDIA: AN EVALUATION OF CLINICAL PERSPECTIVES

Abstract

Introduction: Acute suppurative otitis media is a prevalent inflammatory condition of the middle ear, notably characterized by the presence of purulent exudate. Throughout its clinical history, it has represented a significant challenge, particularly in the pediatric age group, given its incidence and potential to trigger complications. A thorough understanding of its clinical manifestations, underlying etiopathogenesis and natural progression of the disease over time has proven essential for effective clinical management and prevention of long-term sequelae. Scientific publications and studies carried out in the last decade have intensively explored the various facets of this disease, aiming to improve diagnostic tools, optimize therapeutic strategies and unravel the risk factors associated with its occurrence and recurrence. The clinical relevance of acute suppurative otitis media has remained unquestionable, directly impacting the quality of life of patients and imposing considerable costs on health systems on a global scale. Objective. The objective of this systematic literature review was to synthesize and critically evaluate the current clinical perspectives on acute suppurative otitis media, based on the evidence available in the scientific literature published in the last ten years. Methodology: The methodology used in this review strictly followed the recommendations established by the PRISMA checklist. A systematic search was performed in highly relevant electronic databases, including PubMed, SciELO and Web of Science. To cover the topic of interest, the following descriptors were used: "acute suppurative otitis media", "clinical manifestations", "diagnosis", "treatment" and "complications". Studies addressing the clinical perspectives of acute suppurative otitis media in humans, published exclusively in the last ten years, were considered eligible for inclusion, with the express exclusion of publications dated 2021. The exclusion criteria were non-compliance with the stipulated publication period, the study format was not original (such as narrative reviews) and the absence of clinical data pertinent to acute suppurative otitis media. Results: The results obtained from the literature search ratified acute suppurative otitis media as a condition of continued importance in the clinical setting. The main findings highlighted the cruciality of early diagnosis, based on the accurate identification of characteristic otoscopic signs and the careful evaluation of symptoms reported by patients. Antibiotic treatment remained the cornerstone of the therapeutic approach, although publications have consistently highlighted the growing challenge posed by bacterial resistance. Although less common in the post-antibiotic era, complications of acute suppurative otitis media have still been documented, emphasizing the imperative need for constant surveillance and appropriate clinical management of each case. More recent clinical perspectives have highlighted the importance of individualized management, considering the identification and mitigation of both individual and environmental risk factors associated with disease recurrence. Conclusion: In conclusion, acute suppurative otitis media remains a prevalent condition with significant clinical implications. The evidence collected and analyzed in this review reinforced the need for accurate diagnosis and effective and rational therapeutic management, particularly in the context of growing concern about antimicrobial resistance. The emphasis on preventing serious complications and proactively identifying patients at increased susceptibility to recurrence have been central aspects of the clinical perspectives addressed in the scientific literature published in the last decade.