Otitis media

1. Disease of EAR,NOSE,THROAT & management By Mr. ASHOK BISHNOI Lecturer JINR

2. Anatomy & Physiology:-

3. Otology:- The study of disease of the ear. Otalgia :- Pain in the ear due tom disease of jaw joint, neck, throat or teeth. Tinnitus : - The sensation of sound in the ear. Vertigo:- Swimming of the head . Otorrhea :- Any discharge from the ear. Otorrhagia :- Bleeding from the ear. TERMINOLOGY:-

4. Otomycosis :- A fungus infection of the ear causing irritation & inflammation. Deafness: - Loss of hearing . Otoplasty : - Surgical Repair & Reconstruction of the ear. Otorhinolaryngology : - Study of ear, nose & throat disease. Audiometry :- An apparatus for measuring hearing.

5. Tympanoplasty :- It is repairment of tympanic membrane. Myringotomy :- Incision in tympanic membrane.The fluid is section out of middle ear,cavity . Osteitis :- Inflammation in bone. Mastoiditis :- Inflammation of the mastoid antrum and cell.

6. Mastoiditis :-

7. Otitis media Osteosclerosis Menieres disease Perichondritis Permanent sensorineural hearing loss EAR DISORDER:-

8. Definition:- “It is an inflammation of middle ear that most often occur in infant & young children but can occur at any age” OTITIS MEDIA:-

9. Most common in children under 15 yr of age. Incidence:-

10. 1. Acute otitis media 2. Chronic otitis media Other- Serous otitis media Secretory otitis media Suppurative otitis media Classification:-

11. Definition- “It is an acute infection of the middle ear, usually lasting less then 6 weeks” 1.ACUTE OTITIS MEDIA:-

12. Bacteria eg . Streptococcus pneumoniae , H. Influenza Upper respiratory tract infection Infection nasopharynx Etiology :-

13. Due to etiological factor (URTI, Bacteria) Exudates & edema in middle ear Decrease retraction of tympanic membrane Serous exudates in middle ear Pus formation Tympanic membrane rupture ACUTE OTITIS MEDIA Pathophysiology :-

14. Otorrhea Otalgia Fever Rhinitis Tympanic membrane erythema , may be perforated Hearing loss Irritability Clinical Manifestations:-

15. History Physical examination Otoscopic examination Culture Audiometry & Tympanometry Diagnostic evaluation:-

16. Medical Management- Antibiotic Analgesic Antihistamine Surgical management- Myringotomy or tympanotomy (incision in the tympanic membrane) Management

17. Chronic otitis media Hearing loss Perforation Poor speech develop Complication:-

18. Perforation:-

19. Definition:- “It is a long standing infection of a part of whole of the middle year characterised by ear discharge & permanent perforation” OR “Inflammation of the middle ear that lasts for more than 6 weeks” 2.CHRONIC OTITIS MEDIA:-

20. Common in the age 3-6 Incidence:-

21. Inappropriate treatment of acute otitis media. URTI, Allergic rhinitis. Breastfeeding and long time group child care Eustachian tube deformity Septal deviation, cleft palate, sinusitis Etilogy :-

22. Classification:-

23. a.Atico-antral chronic otitis media – Inflammation involves bones (e.g. mastoid, tympanic ring, ossicles ). b. Tubo -tympanic otitis media- Acute otitis media  permanent perforation  muco -purulent discharge. 1.Suppurative(+ perforation)

24. a.Serous Otitis media- Stages : URTI or acute otitis media –> Fluid collection in middle ear and obstruction of eutachian tube  tympanic membrane retraction. Fluid become pus like  necrosis  tympanic membrane perforation. Could end up with mastoiditis ( if not stopped ). 2.Non suppurative -

25. hearing loss Otorrhea Tinnitus Clinical Manifestations:-

26. Medical management- careful suctioning of the ear under microscopic guidance. Instillation of antibiotic drops Surgical management- Tympanoplasty Ossiculoplasty ( surgical reconstruction of the middle ear bones to restore hearing) Mastoidectomy Management:-

27. Assessment:- Collect health history includes a complete description of the ear problem. Collect data about the duration and intensity of the problem, its causes, and previous treatments. Obtain Information about other health problems and medications. Physical assessment includes observation for erythema , edema , otorrhea , lesions, and characteristics such as odor and color of discharge. Nursing management:-

28. Pain R/T Infection Risk for infection R/T eustachian tube dysfunction. Altered auditory sensory perception R/T Fluid in the middle year. Anxiety R/T surgical procedure, potential loss of hearing, Risk for trauma R/T balance difficulties or vertigo during the immediate postoperative period. Nursing diagnosis:-

29. Disturbed sensory perception R/T potential damage to facial nerve (cranial nerve VII). knowledge deficient R/T disease, surgical procedure,and postoperative care.

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