Why does acute otitis media cause ear drum perforation, whereas otitis media with effusion doesn't?

The textbooks say there is no perforation in OME, but why? If there is fluid build-up then surely there is a risk of perforation?

Authored By Carly Bisset on Saturday 12th January 2013


Miss Luna Ibrahim
Medical Student - Warwick
Posted over 7 years ago

Acute otitis media has an infective cause and leads to a build up of pus thus causing increased pressure in the middle ear space and perforation of the tympanic membrane - children usually complain of pain which is relieved when the ear drum bursts. Th