摘要
耳鼻喉醫師對中耳炎的診斷，是基於對疾病的熟悉，及相關診斷技術與工具的應用。臨床上常用的中耳炎診斷方法如下：1)症狀及徵候：急性中耳炎症狀常與上呼吸道感染並存，耳痛及聽力障礙可區別急性中耳炎及外耳炎，耳膿漏表示中耳化膿及耳膜穿孔。2)打氣耳鏡檢查：傳統的耳鏡及反射鏡檢查及清除耳垢仍然重要，鏡檢時觀察鼓膜的形態，顏色，位置，及打氣時的活動性，能藉此得到與鼓室圖檢查相當的診斷率。3)鼓室圖檢查：鼓室圖B型為中耳積液，或鼓膜穿孔。鼓室圖C型在急性中耳炎常見，也可能有中耳積液。對4個月以下的幼兒，高頻率(如1000 Hz)鼓室圖是較佳的選擇。4)聽力檢查：聽力檢查的作用主要在評估中耳炎的影響，以決定治療的方式。積液性中耳炎所致的傳導性聽力損失約為10至30dB，會影響嬰幼兒的語言及認知發展。對嬰幼兒而言，骨導及氣導式聽性腦幹反應，可用來做為客觀的聽力評估。5)鼓膜切開或穿剌：臨床上較少用來做為診斷或篩檢積液性中耳炎。6)影像檢查：臨床上主要用以排除中耳炎的併發症，如乳突炎，膽脂瘤等。7)細菌學檢查：對於有耳膿漏的案例及術後傷口感染的案例，有助於其預防及治療。
並列摘要
The diagnosis of otitis media is based on the diagnostic skill and application of diagnostic tools of the otolaryngologist. The diagnostic methodologies are 1.Symptoms and signs: Symptoms and signs of acute otitis media overlap with upper respiratory illness. Otalgia and hearing impairment may help to differentiate acute otitis media with otitis externa. Acute otitis media with otorrhea includes the presence of purulent discharge of from the middle ear. 2. Pneumatic otoscopy: Visualization of the status, color position of tympanic membrane and assessment of mobility with pneumatic otoscope are one of the standard method for the diagnosis of middle ear disease. Pneumatic otoscopy and tympanometry appear to be equivalent techniques for the identification of middle ear effusion. 3. Tympanometry: There is a type B tympanogram in middle ear effusion and otitis media with perforated ear drum. Type C tympanogram is noted in acute otitis media and sometimes in middle ear effusion. For children under 4 months old, high frequency tympanogram (e.g 1000 Hz) shows promise for detection of middle ear effusion. 4. Hearing test: Hearing assessment is valuable in determining the effect of middle ear disease on hearing function and in making decisions regarding management. Bone-and air-conducted auditory brainstem response are used to assess infants and young children who can not be tested by conventional behavioral techniques. 5. Myrin-gotomy and tympanocentesis: Myringotomy and tympanocentesis are not commonly used in clinical practice. 6. Imaging study: Imaging studies are used to rule out complications of otitis media such as mastoiditis and cholesteatoma. 7. Bacteriologic examination: The results of bacterial examination are helpful in treating and preventing ear with purulent otorrhea and/or post-operative infection.