Who does it affect?

It primarily affects infants and small children and is associated with acute otitis media or chronic suppurative otitis media (infection of the middle ear). It usually presents before the age of 2 yrs with a median age of occurrence of 12 months. In most cases the disease occurs before age 8 yrs and only a small proportion arises in adults. There is some variation in incidence between races but there is no difference between male and female. It can present at any age and in adults it can occur as a new event or a consequence of unresolved childhood ear infection. The condition is common cause of illness in the developing world.