Acute suppurative otitis media

all four stages of acute supperative otitis media

1. Acute S uppurative Otitis Media Arooba Asmat

2. Introduction Acute inflammation of middle ear. Caused by PYOGENIC ORGANISMS.

3. Aetiology More common in infants and children f lower socioeconomic group. Follows viral infection of upper respiratory tract.

4. Routes of infection Via eustachian tube Via external ear Blood borne

5. Predisposing factors Recurrent attacks of common cold. Upper respiratory tract infections. Extanthematous fever like measels , diaphtheria or wooping cough. Infections of tonsils and adenoids. Nasal allergy. Chronic rhinitis and sinusitis. Cleft palate Tumors of nasopharynx

6. Bacteriology Streptococcus pneumoniae 30% Haemophilus influenza 20% Moraxella catarrhalis 12% Streptococcus pyrogenes Staphylococcus aureus Pseudomonas aeruginosa

7. Stages Stage of tubal occlusion Stage of presuppuration Stage of suppuration Stage of resolution Stage of complication

8. 1 . Stage of tubal occlusion Oedema and hyperaemia of nasopharyngeal end of eustacian tube blocks the tube leading to absorption of air and negative intratumpanicpressure . Retracted T.M

9. Symptoms and signs Symptoms Deafness Earache No fever Signs Retracted T.M Loss of light reflex Conductive deafness

10. 2. Stage of presuppuration Prolonged Hyperaemia of lining Inflammatory exudate appears in middle ear T.M become ingested

11. Symptoms and signs Symptoms Earache Disturbed sleep Deafness and tinnitus Fever in children and restlessness Signs Congestion of pars tensa Leash of blood vessels appear along the handle of malleus Cart-wheel appearance T.M become red

12. 3. Stage of suppuration Formation of pus in middle ear. Tympanic membrane starts bulging to the point of repture

13. Signs and Symptoms Symptoms Earache Deafness increases Fever 102-103 F Vomiting Signs T.M appears red and bulging Loss of landmarks Yellow spot on T.M Tenderness Clotting of air cells because of exudate

14. 4. Stage of resolution Tympanic membrane reptures with release of pus Inflamation process begins to resolve

15. Symptoms Signs Evacuation of pus Blood tinged discharge in external auditory meatus Earache relieved Small perfoation in anteroinferior quadrant of pars tensa Fever comes down Hyperaemia of T.M Child feels better

16. 5. Stage of complication Most complicated stage Can lead to Acute mastioditis Subperiosteal abscess Facial paralysis Labyrinthitis Petrositis Extradural absces Meningitis Brain abscess Laterazl sinus thrombophlebitis

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