Acute suppurative otitis media is an infection of the middle ear cavity that occurs more commonly in children and infants, especially during winter/spring and after upper respiratory infections. The infection is usually caused by bacteria like Streptococcus pneumoniae and Haemophilus influenzae. It begins with occlusion of the Eustachian tube and progresses through stages of pre-suppuration, suppuration, and sometimes resolution or complications. Symptoms include earache, fever, hearing loss, and a bulging eardrum. Treatment involves antibiotics, analgesics, myringotomy if needed, and treating any predisposing conditions.
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2. Acute suppurative otitis media is
defined as suppurative infection
involving the mucosa of the middle
ear cleft.
By convention it is termed acute if the
infection is less than 3 weeks in
duration.
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4. It occurs more easily:
In children and infant
In winter and spring
After upper respiratory infection
Measles, diphtheria, tonsillitis,
chronic infection of sinuses and nasal
allergy are other predisposing factors
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7. It is the most common route.
CHILDREN ARE MORE SUCCEPTIBLE:
1. Eustachian tube in infants
and young children is shorter, wider,
more horizontal and less stiff.
2. Large adenoids can interfere with the
opening of the tube
3. Immune system is not fully developed
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8. A small tube connecting the middle ear
to the nasopharynx
FUNCTIONS
1. Regulate and equalize pressure of
middle ear
2. Prevent fluid from accumulating in the
middle ear
3. Protect from the nasopharyngeal
infection
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9. •In children ET is at an angle of 10° while in adults it is at an
angle of 45°.
•ISTHMUS is a narrowing in the ET, at the junction of the
cartilaginous and bony part.
•It is only present in adults.nihar.gupta99@gmail.com 9
10. Associated with TM perforation
Eg. TM trauma, insertion of tympanostomy
tubes, tympanometry, myringotomy
This is an uncommon route
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11. The disease runs through the following
stages:
1. Stage of tubal occlusion
2. Stage of pre-suppuration
3. Stage of suppuration
4. Stage of resolution or
complication
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14. TM retracted
1. Foreshortened
handle of malleus
2. No cone of light
3. Prominent lateral
process of malleus
Conductive
deafness in tuning
fork test
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16. EARACHE
Deafness
Tinnitus
High fever
(children)
Cartwheel
appearance of
TM
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17. Pus increases
TM is compressed, ischemic
TM is tense and bulges
TM necrosis
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18. EXCRUCIATING
PAIN
Deafness
Fever 102-103°F
(Children)
Vomiting
Convulsions
X ray mastoid:
clouding of air
cells due to
exudate.
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19. Follows TM
perforation
Earache relieved at
once
General
condition(temp,
wbc count)
improves
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24. Myringotomy is a surgical procedure in
which a tiny incision is created in
the eardrum to relieve pressure caused
by excessive buildup of fluid, or to
drain pus from the middle ear.
A tympanostomy tube is inserted into the
eardrum to keep the middle ear aerated
for a prolonged time and to prevent
reaccumulation of fluid.
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29. MEATAL FURUNCLE
1. No hearing loss
2. TM is normal
ACUTE MYRINGITIS
1. Severe earache
2. Hearing loss is slight
3. TM: hyperemia and bulla forms
4. After influenza or zoster infection
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