Ottis media n.pptx otitis media infection

otitis media

1. introduction Otitis media refers to an inflammation of the middle auditory canal which is normally filled with air behind the ear drum. It is an inflammation of the middle ear that most often occur in infant but can occur at any age.

2. definition Otitis media (OM) is the inflammation of the middle ear, air filled space behind the tympanic membrane that contains ear ossicles .

3. Otitis media is the second most common disease in child hood after upper respiratory tract infection. Repetitive episodes of acute otitis media can leads to a chronic otitis media which can occur in later life or at any age group.

4. Classification of otitis media Sr. no. Types Characteristic 1. Acute otitis media inflammation of the middle ear and can heal within short time period Rapid onset of symptom <3 weeks 2. Chronic otitis media inflammation of the middle ear due to repetitive episode of AOM Symptom worsen with time >3weeks to 3 month or more

5. Causes/ Risk factors Age: due to shorter eustachian tube its occurrence in childhood is most common Allergies/ Throat infection Water in the ear canal Trauma to the skin of the ear canal, BacteriaL infection- Streptococcus pneumoniae , haemophilus influenzae Passive smoking or Poor air quality (respiratory irritants)

6. Cont.. Gatroesophageal reflux Family history of recurrent acute otitis media Seasonal factors (most common in winters due to pollen allergies) No breast feeding Recurrent upper respiratory infections Craniofacial abnormalities (cleft palate)

7. pathophysiology Due to any infection/ etiological factor inflammation results in exudates and edema in eustachian tube of middle ear Serous exudation (purulent pus formation) in the middle ear. Increase pressure in middle ear cavity Tympanic membrane perforation ( Acute Otitis Media )

8. Recurrent Acute Otitis Media Necrosis of tissue in ear Damage of tympanic membrane Conducting hearing loss, Mastoiditis (Chronic Otitis Media)

9. Sign and symptoms Pain in and around the ear( otalgia ) Fever Drainage from the ear ( Otorrhea ) Tympanic membrane become erythematous Conductive hearing loss Change in behavior (Baby cries) Irritability Noise and Fullness in ear Tugging or pulling the ear Loss of balance Trouble sleeping

10. Diagnostic evaluation History collection Physical examination Otoscopic examination (to assess auditory canal and tympanic membrane) Throat culture

11. Cont.. Audiometry (to test the ablity to hear sounds)

12. Tympanometry (test used to measure the movement of the ear drum)

13. Acoustic reflectometry : test used to measure the sound reflection back to the ear drum.

14. Tympanocentesis : draining out fluid or pus from the middle ear with the help of small needle aspiration.

15. Complication Tympanic membrane perforation Mastoiditis Meningitis Permanent hearing loss Chronic otitis media Facial nerve palsy Brain abscess

16. Medical Management Although most tympanic membrane perforations heal spontaneously in children, Antibiotic Analgesic (NSAIDs) Antipyretic Prevent entry of water in ear Drainage is required if fluid collection is excessive ( Tympanocentesis ). Hearing aid

17. SURGICAL MANAGEMENT Perforations that do not heal on their own may require surgery. Tympanoplasty : surgical repair of tympanic membrane by grafting. Myringotomy : incision through tympanic membrane to create an artificial opening to drain fluid. Ossiculoplasty : surgical reconstruction of the middle ear bones to restore hearing Mastoidectomy : removing diseased mastoid cells

18. NURSING MANAGEMENT PREVENTION Prevent common cold and other illnesses Throat infections should be treated timely Avoid passive smoking to the child Proper nutrition (strong immunity) Avoid water entering the ear Protect ear during swimming Breast feeding should be promoted

19. NURSING INTERVENTIONS Apply hot water bag over the ear with the child lying on the affected side may reduce the discomfort (during the attack of pain). Put ice bag over the affected area may also be beneficial to reduce edema (between pain attacks) For drained ear: external canal may be frequently cleaned using sterile dry cotton swab

20. Cont.. Excoriation of the outer ear should be prevented by frequent cleaning and application of zinc oxide to the surrounding area. Avoid water entering the middle ear and introducing bacteria. Educate family about care of child & keep them aware with the complication of the acute otitis media e.g. hearing loss

21. Cont.. Preventing from Altered Sensory Perception by providing all the needed articles nearby. Avoiding keeping patient alone as it leads to fall or head injury. Promoting wound Healing by preventing errors of medication and proper ear care. Provide emotional support to the child and family