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Acute otitis media
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Acute otitis media

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  • 1. Acute Otitis Media
  • 2. Pathology• Inflammation of the middle ear cleft mucosa and associated ET tube• Acute < 3 weeks• Originate as an infection – bacterial, viral• Bacteria  Streptococcus pneumoniae, Haemophilus influenzae, Morexella catarrhalis ; infants ~20% Gm –ve enterobacteria• Viruses  isolated in 4% RSV, Influenza• Causes a blocked ET  middle ear fluid
  • 3. Children• Horizontal ET• Smaller Lumen• RTI
  • 4. Symptoms• Ear ache• Discharge• Hearing Loss• Fever• Irritability
  • 5. Signs• General Fever Toxic• Local Red TM Perforation Free Field tests  HL WT  RT (-) ve VII / Nystagmus (complications) Mastoiditis
  • 6. Diagnosis• Clinical• Culture + ABST• PTA / Tympanogram
  • 7. Treatment• Antibiotics - Amoxycillin, Co–Amoxyclav• Nasal Decongestants• Steam• Anti-pyretic• Analgesics• Anti-histamines
  • 8. Complications Intratemporal• CHL,SNHL• Perforation• Retraction pocket• Cholestetoma• Tympanosclerosis• Ossicular chain fixation or disconiniuity• Mastoiditis• Petrositis / Gradenigo• Labyrinthitis• PLF• VII• Cholesterol granuloma
  • 9. Complications Intracranial• Extra-dural Abscess• Meningitis• Sub-dural empyema• Focal otitic encephalitis• Lateral Sinus thrombosis• Otitic hydrocephalus• Intracerebral Abscess