otitis media

otitis media, types, diagnosis and treatment.

1. Otitis media (om)

2. Otitis media Otitis media is Latin for inflammation of the middle ear Other name * Otitis media with effusion * Secretory otitis media * Serous otitis media * Catarrhal otitis media * Mucinous otitis media * Glue ear

3. aEtiology The condition may occur due to 1-E.T. obstruction (mostly in children ) 2- allergic hypersensitivity 3- cleft palate and its repair 4-unresolved AOM due to decrease immunity or inadequate treatment. 5-upper respiratory tract infection

4. Types There are several subtypes of OM, as follows: 1- Acute OM (AOM) 2- OM with effusion (OME) 3- Chronic suppurative OM 4- Adhesive OM

5. Signs and symptoms 1- Acute OM (AOM) implies rapid onset of disease associated with one or more of the following symptoms : Otalgia Headache Fever Irritability Loss of appetite Vomiting Diarrhea

6. 2- OM with effusion (OME) often follows an episode of AOM. Symptoms that may be indicative of OME include the following: Hearing loss Tinnitus Vertigo Otalgia 3- Chronic suppurative otitis media is a persistent ear infection that results in tearing or perforation of the eardrum .

7. 4- Adhesive otitis media occurs when a thin retracted ear drum becomes sucked into the middle ear space and stuck . Can be distinguished from each other by the mode of onset and the duration, BUT it is difficult.

8. Complications of acute suppurative otitis media if the infection spreads beyond the middle ear cleft. Complications occurring within the petrous temporal bone include facial palsy, suppurative labyrinthitis and lateral sinus thrombophlebitis, those occurring within the cranial cavity are meningitis, extradural abscess, subdural abscess and brain abscess (in the temporal lobe or cerebellum)

9. Clinical picture: History: * Tonsillitis or adenoid in children * URT infection in adults Hearing loss * Often the only symptom * Usually mild CHL * Usually bilateral but may be unilateral * May be acute or gradual onset

10. Clinical picture: Tinnitus May be present with blowing nose or swallowing Earache May be present especially in the stage of – ve M.E. pressure Vertigo Absent

11. Diagnosis 1- Clinical picture 2- Otoscopic examination + Siegle’s examination Dull T.M + Immobile May be retracted Pale color Fluid level 3- Audiological assessment a- Tympanometry - Type (B) b- audiometry - early stiffness tilt due to T.M. retraction then flat then mass tilt due to increase fluid accumulation. 4-Local ENT examination 5-Radiological assessment

12. Treatment 1- Treatment of the cause * Either medical or surgical * Adenoctomy * Antibiotic * Mucolysis * Nasal vasoconstrictor drops * Corticosteroid

13. 2- Autoinflation refers to the process of opening the eustachian tube by raising intranasal pressure ( eg , by forced exhalation with closed mouth and nose, blowing up a balloon . 3- Myringotomy and suction 4- Tube insertion

14. thank YOU ANY QUASSTION - BY: EATEDAL ALQAHTANI