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. Etiology
• 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