Acute otitis media

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Acute otitis media

  1. 1. Acute Otitis Media
  2. 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. 3. Children• Horizontal ET• Smaller Lumen• RTI
  4. 4. Symptoms• Ear ache• Discharge• Hearing Loss• Fever• Irritability
  5. 5. Signs• General Fever Toxic• Local Red TM Perforation Free Field tests  HL WT  RT (-) ve VII / Nystagmus (complications) Mastoiditis
  6. 6. Diagnosis• Clinical• Culture + ABST• PTA / Tympanogram
  7. 7. Treatment• Antibiotics - Amoxycillin, Co–Amoxyclav• Nasal Decongestants• Steam• Anti-pyretic• Analgesics• Anti-histamines
  8. 8. Complications Intratemporal• CHL,SNHL• Perforation• Retraction pocket• Cholestetoma• Tympanosclerosis• Ossicular chain fixation or disconiniuity• Mastoiditis• Petrositis / Gradenigo• Labyrinthitis• PLF• VII• Cholesterol granuloma
  9. 9. Complications Intracranial• Extra-dural Abscess• Meningitis• Sub-dural empyema• Focal otitic encephalitis• Lateral Sinus thrombosis• Otitic hydrocephalus• Intracerebral Abscess

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