Otitis media is an inflammation of the middle ear that is usually caused by viral or bacterial infections. It most commonly affects young children under 2 years old and is more prevalent in boys, children with family histories of ear infections, and those exposed to passive smoking. Symptoms include ear pain, fever, hearing loss, and irritability. Diagnosis is made through otoscopy which reveals a bulging eardrum with fluid buildup. Treatment involves antibiotics for bacterial infections, while watchful waiting may be sufficient for mild cases in older children. Tympanostomy tubes or adenoidectomy may be used for recurrent or chronic cases.

1. Otitis Media

2. Otitis media
OT
‘GREEK WORD’
MEDIA
LATIN WORD
“ITIS”
EAR
INFLAMMATION
SOMETHING THAT
IS IN THE MIDDLE
VIRUSES :-RSV(Respiratory syncytial virus) and ,INFLUENZA ,
and most likely to precipitate the condition

3.  Most cases of Otitis Media occur in first 24months of life
but the incidence decrease with age except for a small increase at
the age 0f 5 to 6 years where children enter school.
 It don’t occur frequently in children older than 7, pre schooler boys get
affected with this then pre schooler girls.
Children who have a chronic family history of OM
Children living with a large family that also have smokers in it have higher
incidence rate of OM(passive smoking increases the risk of persistent
middle ear effusion by enhancing attachment of the pathogen that causes
otitis to the respiratory epithelium in the middle ear space, by prolonging
the inflammatory response, and by impending drainage through the
eustachian tube)
 Socio economic status and extent of exposure to other children

4. Basic Anatomy of Ear

5. PHYSIOLOGY OF EAR
Through eustachian tube the nerve signals travels to the brain where they are then
translated into recognizable and meaningful sounds. It is the brain that “hears”.
Sound transfers into the ear canal and causes the
eardrum to move
The eardrum will vibrate differently with
different sounds
These sound vibrations make their way
through the ossicles to the cochlea
Sound vibrations make the fluid in the cochlea travel
like ocean waves and created it into nerve impulses

6. Middle ear Cleft
It can be thought as a miniature
of lungs as it
 Allow for ventilation
 Pressure equilibrium
Any problem in this area can
cause ear pathologies

7. EUSTACHIAN TUBE FUNCTION
1.Equalibration of middle ear
with atmospheric pressure
2. Protects middle ear from
reflux of nasopharyngeal content
3. Drains secretions from the
middle ear into the
nasopharyngeal
1.INFECTION
EUSTACHIAN
TUBE OEDEMA
ADENOIDS
HYPERTROPHY
2.FAILING OF
TENSOR VELI
PALATINI
LEVATOR VELI
PALATINI

8. TENSOR VELI PALATINI
LEVATOR VELI PALATINI
 OPENING EUSTACHIAN TUBE
 SWALLOWING
 YAWNING

9. ADULT EUSTACHIAN TUBE
LONGER
VERTICLE
STIFFER
LARGER PASSAGEWAY
CHILD EUSTACHIAN TUBE
SHORTER
HORIZONTAL
SOFTER
SMALLER PASSAGEWAY
All this allow an
easy infection
from the
nasopharynx to
the middle ear

10. Pathophysiology of
Otitis Media

11. Viral
infection
Congestion and
edema
Eustachian tube
Occlusion
-VE pressure in
middle ear
-ve
Accumulation of fluid
in the middle ear
Acute otitis media
Secondary viral or
bacterial infection
Increase pressure
in middle ear
Perforation in the
tympanic membrane
Suppurative Otitis
Media
 OTORRHEA
Chronic Suppurative Otitis Media
Resolved Otitis Media

12. Acute otitis media
Resolved Acute
otitis media
Otitis Media with Effusion
Residual fluid in middle cavity after acute
otitis media –mostly resolves on its own
within 3 months and is asymptomatic
Recurrent otitis media

13. Clinical manifestation
 OTALGIA
 FEVER
 HEARING LOSS
 OTORRHEA
 IRRITABILITY,
 LOSS OF APPATITE
Otitis Media with Effusion
It sometimes causes hearing loss because
of the poor movements of auditory
ossicles in an environment full of fluid
,hence it is a conductive hearing loss
rather than a sensory neural hearing loss

14. Diagnosis
OTOSCOPE
BULDING
EARDRUM
AND BLOOD
VESSELS IN
Acute otitis
media
Suppurative
Otitis Media
Some practitioners also consider the
presence of acute onset of less than 48 hours
of ear pain with the Tympanic membrane
revealing a purulent discolored effusion and
a bulging and a reddened immobile
membrane to be diagnostic factor in AOM.

15. Otitis Media with Effusion

16. Recently the concern about the drug resistant S Pneumonia and other drug resistances have
led infectious disease authority to recommend careful and judicious use of anti-biotics for the
treatment of the illness.
healthy infants order than 6 months of
age, without severe signs and symptoms
Current literature indicates that waiting
up to 72 hours for spontaneous
resolution is safe and appropriate
management of AOM
children younger than 2 years with
uncomplicated AOM.
Some reviews of treatment reveals no
clear evidence that antibiotics improves
outcome
children younger than 2 years who
have persistent acute symptoms of
fever and severe ear pain.
The watchful waiting approach is not
recommended. Oral amoxicillin in high
dose (80-90mg/kg/day divided twice
daily is the treatment of choice for initial
episode of AOM.

17. In infants younger than 6 month should be treated with antibiotics
because of their immature immune
system and the potential for infection
with bacteria.
Antibiotic therapy in severe AOM is 10-14 days in children of the age 6 years &
older with an uncomplicated AOM
with a moderate and mild infection a 5-7 day course maybe sufficient.
Second line antibiotics includes cephalosporin and injection and IM ceftriaxone
is used of the causative organism is a highly resistance pneumococcus.
Application of heat and cold and tropical pain relief drops.
Antibiotics ear drops have no value in treating in AOM.

18. Otitis Media with Effusion
 Recurrent otitis media
 Hearing loss
 Developmental delays or learning
difficulties
Tympanostomy tube
MYRINGOTOMY
A SURGICAL INCISION IN
THE EARDRUM IN CASE
OF MASTODITIS AND
FACIAL PALSY

19. A MINIMAL INVASIVE LASER
ASSISTED MYRIGOTOMY
PROCEDURE
ADENOIDECTOMY IS ALSO
PERFORMED IN RECURRENT
CHRONIC OTITIS MEDIA