🔵 Otitis media

🔵 Otitis media #shortnote

Definition:-

“It is an inflammation of middle ear that most often occur in infants and young children but can occur any age”.

clinical manifestations:-

.otalgia

.Otorrhea

.fever.

.Rhinitis.

.hear loss.

. irritability

. tympanic membrane erythema ,may be perforated.

Classification:-

1.acute otitis media.

2.chronic otitis media.

1.Acute otitis media:-

“It is an acute inflammation of the middle ear , usually lasting less than 6 weeks”

Pathophysiology:-

Diagnostic evaluation:-

History collection, physical examination, otoscopic examination, culture, audiometry &tympanometry.

Complication:-

. chronic otitis media

. hearing loss

. perforation

.poor speech develop.

Management:-

(, medical management):-

. antibiotics

. analgesic

. antihistamine

(Surgical management):-

. myringotomy or tympanometry

(incision in the tympanic membrane).

2. Chronic otitis media:-

Definition:-

“it is a long standing infection of a part of whole of the middle year characterised by ear discharge and permanent perforation”.

or.

“inflammation of the middle ear that lasts for more than 6weeks”

Etiology:-

Inappropriate treatment of acute otitis media.

.URTI, Allergy rhinitis.

. Breast feeding.

.long time group child care.

. Eustachian tube deformity.

.setal deviation ,

.cleft palate ,

.sinusitis.

Clinical manifestations:-

. hearing loss.

. otorrhea

tinnitus.

Management:-

( medical management):-

.carefully suctioning of the ear under microscopeic guidance.

. institution of antibiotics drops.

(surgical management):-

.tympano plasty.

.ossiculoplasty

(surgical reconstruction of the middle ear bones to restore hearing)

………………………..

●Pathophysiology
-Middle ear inflammation.
-Pathogens: Strep. pneumo, nontypeable H. influenzae, Moraxella.
-75% occur <10 years old, especially 6-18 months.

●Risk factors
-Smoking
-URTI
-Bottle-feeding and dummy use.
-Adenoids
-Anatomical malformations.

●Signs and symptoms
:Acute otitis media:
-Sudden pain and fever.
-Inflammed, bulging ear drum, or purulent discharge and resolution of pain if it has burst.
-May follow URTI.
-Other possible symptoms: irritability, anorexia, and vomiting.

:Chronic otitis media:
-Several months of symptoms.
-Fluid discharge.

●Management
-Usually self-resolves within 3 days, but can last up to 1 week.
-Consider amoxicillin for 5 days if: perforated tympanic membrane (and/or discharge in ear canal), ≥4 days symptoms, or bilateral OM <2 years old.

●Complications
-Glue ear.
-Chronic suppurative otitis media: foul discharge, ↓hearing, drum perforation
-Infection spread: mastoiditis, petrositis, labyrinthitis, meningitis.
-Facial palsy.
-Abscess

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