this contain detailed information about introduction, definition, causes, risk factor,treatment, medical and surgical management, nursing care given to the patient ,patient teaching.

1. OTITIS MEDIA
Submitted by
Purnima Kumari
Roll no – 25
Basic BSC Nursing 3rd year
College of Nursing
RIMS Ranchi
Submitted To
Mrs Mamta Toppo
Associate professor
College of Nursing
RIMS Ranchi.

2. CONTENTS
• Introduction
• Classification
• Acute otitis media
• Otitis media with effusion
• Chronic suppurative otitis
media
• Medical management
• Surgical management
• Complications
• Prevention
• Nursing management
• Patient education
• New research
• Summary
• Evaluation
• Reference
• Bibliography

5. Introduction
• It is a middle ear infection.
• Otitis means inflammation of the ear and media
means middle.
• Most often occur in infants and young children
but can occur at any age.
• Inflammation often begins with infection that
cause sore throat , colds , other respiratory
problems and spreads to the middle ear
• Caused by virus or bacteria and can be acute or
chronic

6. Definition
Otitis media is inflammation of the middle ear or
middle ear infection.
• Otitis media is a general term refers to inflammation
of the mucous membranes of the middle ear
eustachian tube and mastoid

8. Classification
1. Acute otitis
media
2. Otitis media
with effusion
3. Chronic
suppurative
otitis media

9. Acute otitis media
1. Also known as suppurative otitis media or
purulent otitis media.
2. It is an acute inflammation and infection of the
middle ear mucosa.
3. Caused by pyogenic bacterial organisms which
enter into middle ear via eustachian tube.
4. Usually rapid onset and short duration.

10. Etiology and risk factors
• Bacterial eg . Streptococcus pneumoniae, Haemophilus
influenzae, and moraxella species
• Upper respiratory tract infection
• Rhinovirus and respiratory syncytial virus
• Prematurity and low birth weight
• Family history and genetic predisposition
• Deviated nasal septum and nasal polyps
• Vitamin A , zinc and iron deficiency.

12. Pathology
Stage of tympanic congestion
Stage of exudation
Stage of suppuration
Stage of convalescence or
recovery
Stage of coalescent mastoiditis

13. Clinical manifestations
• Sudden and severe earache ( otalgia)
• Tinnitus
• Hearing loss
• Fever
• Sense of fullness in ear
• Irritability
• Mastoid tenderness
• Tympanic membrane erythema, may be perforated.

14. Diagnostic evaluation
• History taking
• Physical examination
• Culture and sensitivity test
• C T scan , MRI .
• Audiometry and tympanometry
• Nasopharyngoscopy

17. Management
• Medical management
1. Antibiotic – Amoxicillin , Amoxicillin – clavulanate.
2. Analgesic
• Surgical management
1. Myringotomy
2. Tympanocentesis

18. Myringotomy

19. Otitis media with effusion
• Also know. as serous and secretory otitis media
• It is simple a collection of fluid that occur within middle
ear space as a result of the negative pressure produced
by altered eustachian tube function.
Causes
• Viral URI
• Bactetial infection
• Acute otitis media.
• Breast feeding in lying down

20. • Fluid in the middle ear sometimes causes conductive hearing
impairment.
• Fluid may become very thick and glue like.( Glue ear).
Clinical manifestations
• Non purulent effusion either mucoid or serous
• Hearing losss
• Aural fullness.
Hearing loss is generally mild and is often detected only with
an audiogram.

23. Treatment
1. Antimicrobial agents- Antibiotic such as
erythromycin, sulfisoxazole, Amoxicillin,
Amoxicillin clavulanate.
2. Surgery – Tympanocentesis , Laser myringotomy
alternate to ear tube surgery.

24. Chronic suppurative otitis media
• It is a chronic inflammation of the middle ear with tissue
damage, usually caused by repeated episode of the acute
otitis media
• Develops after a prolonged period of time with fluid or
negative pressure behind the tympanic membrane.
• Perforated ear drum

26. Etiology
• Inappropriate treatment of acute otitis
media.
• URTI, allergic rhinitis
• Eustachian tube dysfunction
• Adenoid hypertrophy and chronic
sinusitis.

27. Classification
1. Tubotympanic type
• Tubal type
• Tympanic type
2. Atticoantral disease

30. Clinical manifestations
• Persistent blockage of fullness of ear.
• Hearing loss
• Chronic foul smelling ear drainage
• Vertigo
• Facial weakness
• Ear pain and headache
• Fever
• Tenderness of mastoid process
• Middle ear mucosa is red edematous and swollen.

31. Diagnostic evaluation
• Laboratory studies- culture and sensitivity of a
specimen
• Radiography
• CT scan
• MRI
• audiogram

33. Medical management
1. Antibiotic – fluoroquinolones otic preparation with or
without corticosteroid
2. Aural toilet
3. Control of granulation tissue – tropical antimicrobial
drops
4. Treatment of underlying cause.

34. Surgical management
1. Myringoplasty
2. Myringotomy
3. Tympanoplasty
4. Ossiculoplasty
5. OtoLAM
6. Adenoidectomy
7. mastoidectomy

35. Complications
Intra temporal
• Mastoiditis
• Petrositis
• Facial paralysis
• Labyrinthitis
Intra cranial
• Meningitis
• Subdural abscess
• Brain abscess
• Lateral sinus
thrombophlebitis

36. Prevention
• Keeping a child away from Children with colds or
upper respiratory tract infections
• Not exposing the child to tobacco smoke
• Feeding child in an upright position
• Vaccine that protects pneumonia.

37. Nursing management
• Assessment:
• Collect health history includes a completedescription
of the ear problem.
• Collect data about the duration and intensity of the
problem, its causes, and previous treatments.
• Obtain Information about other health problems and
medications.
• Physical assessment includes observation for
erythema, edema, otorrhea, lesions, and
characteristics such as odor and color of discharge.

38. Nursing diagnosis
1. Pain related to inflammation and pressure on
tympanic membrane
2. Risk for infection related to eustachian tube
dysfunction
3. Impaired verbal communication related to hearing
deficit
4. Altered auditory sensory perception related to
middle ear infection
5. Fear and anxiety related to progression of disease.

39. Patient education
• Teach patient or caregiver to administer ear
medication. Drop should be administered at room
temperature to avoid pain and dizziness.
• Intruct patient or caregiver in safe techniques for
cleaning ears. Thin washcloth and fingers are best for
cleaning ears.
• Instruct patient in the importance of routine
examination by an audiologist

40. New research

41. Abstract
Introduction: Chronic suppurative otitis media (CSOM) is a major
health problem throughout the world in underdeveloped and
developing countries including India The high prevalence of CSOM in
school children in India has led us to undertake this study in school
going children of rural and urban areas of Muzaffarnagar, Uttar
Pradesh and to find out the various predisposing factors for the
development of CSOM.
Objectives: The objective is to find out the prevalence of CSOM in
school going children of the rural and urban population about age,
sex, and socioeconomic status Materials and Methods: Students were
randomly selected from primary schools in rural and urban areas of
Muzaffarnagar, Uttar Pradesh Cases selected was categorized in
relation to age, sex, socioeconomic status, and prevalence of the
safe and unsafe type of CSOM.

42. Observations: In the present study, a cross sectional survey was conducted in
2158 school children between the age group of 5 and 15 years. A total of 1161
children belonged to urban school whereas 997 children were from three
adjacent rural government schools. A total of 78 children were found to be
suffering from either unilateral or bilateral CSOM
Conclusion: The prevalence of CSOM in urban school children was 2.32%, while
for rural children, it was 5.11% .42.10% of cases of CSOM belonged to upper-
lower socioeconomic group followed by lower middle group (31.57%). The
tubotympanic disease was present in 87.18% of CSOM cases while 12.82% had
atticoantral disease. Active CSOM was found amongst 37.18% while 62.82% had
inactive disease. 42.10% had smoking father. 36 84% had indoor cooking with
kerosene oil exposure, and 34.21% used unhygienic ear cleaning methods
31.58% had a history of recurrent URL 28.95% had chronic tonsillitis, and
21.05% of children had domain name system as associated findings with CSOM.
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43. Summary

44. Evaluation
• What is otitis media
• Enlist type of otitis media
• Describe acute otitis media .
• What are the diagnosis evaluation of otitis media
• What are the clinical manifestations of serous otitis
media
• What are the complications of otitis media
• How you prevent otitis media.
• Describe Nursing management of otitis media

45. Reference
• Book
• Internal
• Discussion with teacher

46. Bibliography
• Ansari Javed, textbook of medical surgical nursing,
volume – 2, PV publications, page no- 34 to 36
• www.wikipedia.org
• www.slidshare.net
• www.indianjotol.org
• www.google.com