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Otitis Media
- 1. OTITIS MEDIA Presented By Sarju Maharjan ACAS, BSN 3rd year
- 2. DEFINITION • Inflammation of middle ear • Most common infection of infancy and childhood • common between 6months and 2 years of age
- 3. RISK FACTORS • Young age/Allergies • Cold/URTI/Sinus infection • Congenital anamolies • Immune deficiency • Bottle feeding
- 5. TYPES • Acute otitis media(AOM) • Otitis media with effusion(OME) • Chronic suppurative otitis media(CSOM)
- 6. ACUTE OTITIS MEDIA • Painful type of ear infection • Comes quickly and lasts less than 3 weeks • usuallly associated with URTI, measles
- 7. CAUSES • Streptococcus pneumonia • Hemophilus influenza • Allergic rhinitis • Tympanic membranes perforations
- 8. PATHOPHYSIOLOGY • Stage of tubal occlusion • Stage of presuppuration • Stage of suppuration • Stage of resolution • Stage of complication
- 11. Clinical Features • Pain and discomfort • Fever • Irritability,restlessness,crying • Ear discharge(ruptured tympanic membranes) • Hearing impairment
- 12. MANAGEMENT • Antibiotic therapy • Symptomatic therapy • Dry heat • Myringotomy • Tympanocentesis • Mastoidectomy
- 13. OTITIS MEDIA WITH EFFUSION • Insidious condition • Follows AOM treated appropriately with antibiotics • Accumulation of non purulent effusion
- 14. PATHOLOGY • Malfunctioning of eustachian tube • Increased secretory activity of middle ear mucosa
- 15. CLINICAL FEATURES • Hearing impairment • feeling of fullness • Mild earaches • Delayed and defective speech
- 16. MANAGEMENT • some cases spontaneously resolve within 3 months • Antibiotics,Decongestants • Valsalva manoevre • Politzerization • Myringotomy • Grommet insertion
- 21. CHRONIC SUPPURATIVE OTITIS MEDIA • Chronic ,recurrent infection lasting more than 3 months • Pain rarely present • Result of neglected acute infections • Affects learning ability of child
- 22. CAUSES • Pseudomonas auregenosa • Staphylococcus aureus • Klebsiella • Proteus
- 23. PATHOPHYSIOLOGY Repeated Irritation and inflammation Mucosal Ulceration Formation of Granulation Tissue Destruction of bony margins Different complications
- 25. TUBOTYMPANIC CSOM • Safe type of CSOM • Involves Antero-inferior part • Hearing loss not present • Non offensive Mucoid or mucupurulent discharge
- 27. ATTICOANTRAL CSOM • Unsafe type of CSOM • Involves posterosuperior part of middle ear • Associated with bone eroding process • Brownish ,greenish, offensive discharge present • Marginal perforation
- 28. CLINICAL FEATURES • Recurrent ear discharge • Hearing loss of varying degree • Perforation of Tympanic membrane
- 30. MEDICAL MANAGEMENT • Oral broad spectrum antibiotics like penicillin, amoxicillin,erythromycin • Topical antibiotics drops • Management of URTI or allergy • Mopping or suctioning of discharge
- 31. SURGICAL MANAGEMENT •MYRINGOPLASTY •CORTICAL MASTOIDECTOMY •RADICAL MASTOIDECTOMY •TYMPANOPLASTY