OTITIS MEDIA.pptx

otitis media, notes and ppt

1. MRS. M.J. SYLVIA JOICE., M.SC (N), LETURER, DEPT OF MEDICAL SURGICALNURSIG, GANGA COLLEGE OF NURSING.

2. MRS.SYLVIA JOICE.M.J. LECTURER, MEDICAL SRGICAL NURSING. OTITIS MEDIA

3. DEFINITION: Inflammation of the mucus membrane of the middle ear, eustachian tube and the mastoid bone.

4. TYPES OF OTITIS MEDIA: 1 . SUPPURATIVE OTITIS MEDIA (SOM) : a. Acute Suppurative otitis media (ASOM) b. Chronic Suppurative otitis media (CSOM) i . Atico – antral type ii. Tubo -tympanic type

5. 2. NON SUPPURATIVE OTITIS MEDIA 3. ADHESIVE OTITIS MEDIA 4. BARO-TRAUMATIC OTITIS MEDIA 5. TUBERCULAR OTITIS MEDIA

6. 1. SUPPURATIVE OTITIS MEDIA: a. Acute Suppurative otitis media (ASOM): It is an acute painful type of middle ear infection and inflammation of the mucosa of middle ear cleft with suppuration usually lasting less than six weeks

7. b. Chronic Otitis media (CSOM) : It is the long standing infection of the middle ear with inflammation. It lasts for more than six weeks. It is characterized by ear discharge and tympanic membrane permanent perforation

8. i . Atico -antral otitis media : Inflammation involves mastoid bone tympanic membrane and ossicles ii. Tubo -tympanic otitis medi : It is acute inflammation with muco - purulent discharge and permanent tympanic perforation.

9. 2. NON SUPPURTIVE OTITIS MEDIA [NSOM] It is also called as Serous / Secretory otitis media (SOM) Otitis media with effusion (OME) Collection of fluid in middle ear due to negative pressure produced by obstruction of eustachian tube and tympanic membrane retraction

10. 3. ADHESIVE OTITIS MEDIA: If fluid is present in the middle ear for a prolonged period, the tympanic membrane retracts and will become adhesive . Tubercular otitis media: Persons infected with mycobacterium tubercle or suffering with tuberculosis will cause middle ear infection and inflammation.

11. 4. TUBERCULAR OTITIS MEDIA: Persons infected with mycobacterium tubercle or suffering with tuberculosis will cause middle ear infection and inflammation .

12. 5. BARO-TRAUMATIC OTITIS MEDIA: Normally, Eustachian tube opens by muscular action & allows air pressure within middle ear adjusted with the atmosphere Failure or inability- causes “Locked”. Due to ascent in aircraft, the air pressure decreases and descent in aircraft the air pressure increases It leads to difference in atmospheric and intra-tympanic pressure ( >90mmHg)

13. eTIOLOGY : Bacteria Virus Tumor Polyps Measles Nasal pack Cleft palate Perforation Trauma

14. ETIOLOGY Cont : Upper Respiratory tract infections Deviated nasal septum Palatal paralysis Short & wide eustachian tube Immunological disorders of middle ear mucosa Allergies: Dandruff, soaps, hair sprays, hair dyes etc.

15. Pathophysiology: URTI, BACTERIA AND OTHER ETIOLOGY EXUDATES & EDEMA IN MIDDLE EAR ECREASE TERACTION OF TYMPANIC MEMBRANE SEROUS EXUDATES IN MIDDLE EAR PUS FORMATION RUPTURE OF THE TYMPANIC MEMBRANE OTITIS MEDIA

16. Clinical manifestations: Otalgia (ear pain) Deafness (Unilateral & Bilateral) Tinnitus (ringing sound in ear) Vertigo (dizziness) Defect in language & speech Fever (>101- 103 degree F) Malaise , Vomiting

17. Otorrhoea (Profuse foul smelling discharge) Tympanosclerosis Scarring of tissues After rupture results in Decreased pain Reduced temperature Decreased mastoid tenderness

18. Diagnostic investigations: Hearing assessment – reveals impairment in hearing Bacteriology – Culture represents the type of bacterial infection Radiology- represents inflammatory process of mastoid bone Allergic test- able to identify causative factor for inflammation of ear and immunologic status Blood study- reveals elevated levels of leucocytes, neutrophils, cholesterol

19. Medical management: Aim – To control infection To ensure complete resolution Symptomatic relief Ensure patency for drainage, ventilation

20. 1. Active stage: Antibiotics , decongestant, antihistamines to be given Symptomatic relief- Bed rest, fluid increase, analgesic, antipyretics, dry heat application Local treatment- if perforated A. Aural Toilet (Dry mopping)-cleaning ear with sterile cotton tipped probe/microscope B . Culture sensitivity

21. Tubercular otitis media: General treatment: Anti tubercular drugs ii. Local treatment: Aural toileting- cleaning ear with sterile cotton tipped probe Insufflations of streptomycin powder

22. 2. Quiescent stage: Tetanus immunization All inattentive and dull persons to be investigated for middle ear effusion and deafness Sinusitis – to be controlled Removal of adenoids Immunological disorders to be corrected

23. Follow precautions: Sniffing habits – to be stopped Plug ear during hair wash Avoid the following entry of water in ear during swimming and diving cleaning with dirty cotton or linen

24. 3. In active stage: If ear remains dry for 3-6 months closure of perforation to be done Adenoidectomy ( removal of adenoids) Septoplasty (repair of septum) Aural polypectomy (removal of polyp) Myringoplasty (repair of tympanic membrane)

25. 4. Healing stage: Ensures complete resolution Full auditory function

26. Complications: 1. Mastoiditis : inflammation of the mastoid process 2. Petrositis : inflammation of temporal bone 3. Facial nerve palsy: paralysis of facial muscles

27. 4. Brain abscess: collection of pus in cavity of brain cells 5. Labyrinthitis : inflammation of inner ear 6. Meningitis : inflammation of coverings of brain 7. Abscess : It is the formation of cavity and collection of pus

28. Nursing management: Collect health history including complete description about ear problem Collect data about the duration, intensity of the problem, its causes and previous treatments Obtain information about other health problems & medications Physical assessment includes observation for erythema, edema, otorrhoea, lesions and characteristics such as odor and color of discharge.

29. Nursing diagnosis: Pain in ear related to inflammation of middle ear cavity or surgical procedure Hyperthermia related to infection of the middle ear Ineffective individual coping related to impaired hearing acuity, fluid collection Altered auditory sensory perception related to preoperative hearing loss, fluid in middle ear Risk for infection related to tubal occlusion in middle ear