Otitis Media

Infections of Ear

1. OTITIS MEDIA Presented By Sarju Maharjan ACAS, BSN 3 rd 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

4. TYPES Acute otitis media(AOM) Otitis media with effusion(OME) Chronic suppurative otitis media(CSOM )

5. ACUTE OTITIS MEDIA Painful type of ear infection Comes quickly and lasts less than 3 weeks usuallly associated with URTI, measles

6. CAUSES Streptococcus pneumonia Hemophilus influenza Allergic rhinitis Tympanic membranes perforations

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

8. Clinical Features Pain and discomfort Fever Irritability,restlessness,crying Ear discharge(ruptured tympanic membranes) Hearing impairment

9. MANAGEMENT Antibiotic therapy Symptomatic therapy Dry heat Myringotomy Tympanocentesis Mastoidectomy

10. OTITIS MEDIA WITH EFFUSION Insidious condition Follows AOM treated appropriately with antibiotics Accumulation of non purulent effusion

11. PATHOLOGY Malfunctioning of eustachian tube Increased secretory activity of middle ear mucosa

12. CLINICAL FEATURES Hearing impairment feeling of fullness Mild earaches Delayed and defective speech

13. MANAGEMENT some cases spontaneously resolve within 3 months Antibiotics,Decongestants Valsalva manoevre Politzerization Myringotomy Grommet insertion

14. 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

15. CAUSES Pseudomonas auregenosa Staphylococcus aureus Klebsiella Proteus

16. PATHOPHYSIOLOGY Repeated Irritation and inflammation Mucosal Ulceration Formation of Granulation Tissue Destruction of bony margins Different complications

17. TYPES TUBOTYMPANIC CSOM ATTICOANTRAL CSOM

18. TUBOTYMPANIC CSOM Safe type of CSOM Involves Antero-inferior part Hearing loss not present Non offensive Mucoid or mucupurulent discharge

19. ATTICOANTRAL CSOM Unsafe type of CSOM Involves posterosuperior part of middle ear Associated with bone eroding process Brownish ,greenish, offensive discharge present Marginal perforation

20. CLINICAL FEATURES Recurrent ear discharge Hearing loss of varying degree Perforation of Tympanic membrane

21. MANAGEMENT MEDICAL MANAGEMENT SURGICAL MANAGEMENT

22. MEDICAL MANAGEMENT Oral broad spectrum antibiotics like penicillin, amoxicillin,erythromycin Topical antibiotics drops Management of URTI or allergy Mopping or suctioning of discharge

23. SURGICAL MANAGEMENT MYRINGOPLASTY CORTICAL MASTOIDECTOMY RADICAL MASTOIDECTOMY TYMPANOPLASTY

24. NURSING MANAGEMENT