OTITIS MEDIA.pptx

Otitis media BSC (N)

1. OTITIS MEDIA mastoiditis

2. DEFINITION Otitis media is the inflammation of the mucous membrane of the middle ear , Eustachian tube and mastoid process

3. TYPES ACUTE OTITIS MEDIA SEROUS OTITIS MEDIA CHRONIC SUPPURATIVE OTITIOS MEDIA

4. ACUTE OTITIS MEDIA Definition : acute otitis media is an acute infection usually lasting less than 6 wks

5. E tiology Entrance of pathogenic bacteria into the middle ear. Infections of upper respiratory tract such as rhinitis , sinusitis. Inflammation of surrounding tissue Perforation of tympanic membrane Allergic reaction Bacterial infection

6. Risk factor Yong age Congenital abnormalities Immune deficiency Male gander Family history of otits media

7. CLINICAL MANIFESTATION Otalgia Hearing loss tinnitus Bulging of tympanic membrane Fever Discharge from ear Erythematous tympanic membrane

8. DIAGNOSTIC EVALUATION History collection Physical examination Mastoid x-ray Hearing test Ear drainage culture Antibiotic sensitivity test Otoscopic examiniation

9. MANAGEMENT Control the infection by administration of antibiotics eg:ampicillin,amoxicilin Administer analgesics Administer anti-inflammatory drugs Nasal decongestants

10. SURGICAL MANGEMENTS Myringotomy ( tympamotomy ): inthis procedure an incision is made on the tympanic membrane to relive pressure and to drain serous or purulent fluid from middle ear

11. complications Chronic otitis media Meningitis Brain abscess Facial nerve paralysis Lateral sinus thrombosis Intracranial complication Marked mastoiditis

12. SEROUS OTITIS MEDIA(SOM) Definition:SOM is the presence of fluid in the middle ear without evidence of an active infection.

13. ETIOLOGY/RISK FACTORS Radiotherapy Barotrauma Eustachian tube obstruction Upper respiratory tract infection Carcinoma of Eustachian tube Allergic condition Child hood

14. CLINICAL MANIFESTATION Hearing loss Fullness in the ear Congestive sensation Popping and cracking noises Tympanic membrane will appear dull Air bubbles in middle ear

15. DIAGNOSTIC EVALUATION History collection and physical examination Audiometry Otoscopy audiogram

16. MANGEMENT MYRINGOTOMY CORTICOSTEROIDS TO REDUCE EDEMA

17. CHRONIC SUPPURATIVE OTITIS MEDIA(CSOM) DEFINITION:CSOM is a condition that occurs due to repeated episodes of acute otitis media and characterized by irreversible tissue pathology .it is associated with persistent perforation of tympanic membrane.

18. ETIOLOGY /PREDISPOSING FACTORS Eustachian tube dysfunction Antibiotic resistant Arthritis Granulated tissue

19. Clinical manifestations Hearing loss Cholesteatoma Pain in ear Persistent or intermittent foul smelling Perforated tympanic membrane Episodes of dizziness Purulent , mucoid and serous drainage from ear

20. DIAGNOSTIC EVALUATION History collection Physical examination Mastoid x ray Otoscopic examination Culture and sensitivity test of middle ear drainage

21. MANAGEMENT MEDICAL MANAGEMENT Apply antibiotic powder Careful suctioning and cleansing Optic drops Administer analgesics Antiemetics Systemic antibiotics.

22. SURGICAL MANAGEMENT Tympanoplasty to prevent recurrent infection Mastoidectomy to remove cholesteatoma Ossiculoplasty is done to reconstruct the middle ear bones to restore hearing.

23. NURSING MANAGEMENT OF OTITIS MEDIA 1 . nursing diagnosis : “ acute pain related to inflammation and increased middle ear pressure evidenced by crying episodes” Desired outcome: patient will experience pain relief. Nursing interventions: Assess the pain by pain rating scale Provide comfortable position Avoid activity or exposure that aggravate pain

24. Encourage the patient to take aggravate pain Encourage the patient to take liquid or soft diet Administer analgesics to relieve pain

25. 2) nursing diagnosis: impaired sensory perception related to auditory nerve damage infection and edema of middle ear evidenced by absence of respond to sound Nursing interventions: assess the patient hearing ability frequently Reasure the patient and his family members that hearing loss is not permanent

26. Provide peaceful and comfortable environment. Encourage patient to communicate with patient in loud and clear voice.

27. Nursing diagnosis: risk for infection related to presence of infection possible evidenced by irritability and pain in ear. Nursing intervention: Regular monitoring of ear Encourage the patient to take proper nutrition and increased fluid intake.

28. MASTOIDITIS

29. Mastoiditis is an inflammation of mastoid process. CAUSATIVE AGENT: Staphylococcus aureus Moraxella catarrhalis Mycobacterium pyogenes Pseudomonas aeruginosa

30. Etiology and risk factor Ear infection Allergy Passive smoking Low socio economic status Previous history of acute media

31. Clinical manifestation Head ache Earache Fever Loss of hearing Swelling around affected ear Ear discharge Local tenderness Nausea and vomiting Perforation of ear drum

32. Diagnostic evaluation History collection Physical examination Skull x ray CTscan MRI CBC

33. MANAGEMENT Administer antibiotic iv or oral. Surgery to remove part of mastoid bone to drain infected fluid

34. complication Partial or complete hearing loss Meningitis or brain abscess vertigo epidural abscess Destruction of mastoid bone Vision change Facial parlysis