Otitis media is a group of inflammatory diseases of the middle ear. The two main types are acute otitis media (AOM) and otitis media with effusion (OME). AOM is an infection of rapid onset that usually presents with ear pain.

1. Otitis media
Presented By:
Mr. Abhay Rajpoot

4. INTRODUCTION
• An ear infection (sometimes called acute otitis media) is an infection of the
middle ear, the air-filled space behind the eardrum that contains the tiny
vibrating bones of the ear. Children are more likely than adults to get ear
infections

5. DEFINITION
It is accumulation of the fluid in middle ear, the space between tympanic membrane
and inner ear. The middle ear is usually filled with air but sometimes get filled with
mucus and fluid. Some time this mucus can get infracted sometimes with pathogens
called an ear infection. It is most common paediatric problem.

7. RISK FACTORS
• Age. Children between the ages of 6 months and 2 years are more
susceptible to ear infections because of the size and shape of their
eustachian tubes and because their immune systems are still developing.
• Group child care. Children cared for in group settings are more likely to get
colds and ear infections than are children who stay home. The children in
group settings are exposed to more infections, such as the common cold.
• Infant feeding. Babies who drink from a bottle, especially while lying
down, tend to have more ear infections than do babies who are breast-
fed.

8. CONTI…
• Seasonal factors. Ear infections are most common during the fall and
winter. People with seasonal allergies may have a greater risk of ear
infections when pollen counts are high.
• Poor air quality. Exposure to tobacco smoke or high levels of air
pollution can increase the risk of ear infections.
• Alaska Native heritage. Ear infections are more common among
Alaska Natives.
• Cleft palate. Differences in the bone structure and muscles in children
who have cleft palates may make it more difficult for the eustachian
tube to drain.

9. AETIOLOGY
• Bacteria (Streptococcus pneumonia)
• Virus
• URI (Upper respiratory tract infection) Ex. Sinsuitis
• Allergic reaction
• Inadequate treatment of acute otitis media

11. CLINICAL MANIFESTATIONS
Children
• Ear pain, especially when lying down
• Tugging or pulling at an ear
• Trouble sleeping
• Crying more than usual
• Fussiness
• Trouble hearing or responding to sounds
• Loss of balance

12. CONTI…
• Fever of 100 F (38 C) or higher
• Drainage of fluid from the ear
• Headache
• Loss of appetite

14. CONTI…
Adults
• Ear pain
• Drainage of fluid from the ear
• Trouble hearing

15. DIAGNOSTIC EVALUATION
• History Collection
• Physical examination
• Tympanometry. This test measures the movement of the eardrum. The
device, which seals off the ear canal, adjusts air pressure in the canal, which
causes the eardrum to move. The device measures how well the eardrum
moves and provides an indirect measure of pressure within the middle ear.
• Acoustic reflectometry. This test measures how much sound is reflected
back from the eardrum — an indirect measure of fluids in the middle ear.
Normally, the eardrum absorbs most of the sound. However, the more
pressure there is from fluid in the middle ear, the more sound the eardrum
will reflect.
• Tympanocentesis. Rarely, a doctor may use a tiny tube that pierces the
eardrum to drain fluid from the middle ear — a procedure called
tympanocentesis. The fluid is tested for viruses and bacteria. This can be
helpful if an infection hasn't responded well to previous treatments

17. COMPLICATIONS
• Impaired hearing.
• Speech or developmental delays.
• Spread of infection
• Tearing of the eardrum.

18. PREVENTION
• Prevent common colds and other illnesses.
• Avoid secondhand smoke.
• Breast-feed baby.
• While bottle-feeding, hold baby in an upright position.

19. MANAGEMENT
Antibiotic therapy
• After an initial observation period, your doctor may recommend antibiotic
treatment for an ear infection in the following situations:
• Children 6 months and older with moderate to severe ear pain in one or
both ears for at least 48 hours or a temperature of 102.2 F (39 C) or higher
• Children 6 to 23 months with mild middle ear pain in one or both ears for
less than 48 hours and a temperature less than 102.2 F (39 C)
• Children 24 months and older with mild middle ear pain in one or both
ears for less than 48 hours and a temperature less than 102.2 F (39 C)

20. CONTI…..
• Pain medication (Analgesics Drug)
• Broad Spectrum antibiotic therapy ( Penicillin)
• NSAIDs Drugs

21. SURGICAL MANAGEMENT:
• Myringotomy: incision through eardrum to create an artificial opening
either to allow infected fluid to drain from the middle ear in acute
otitis media
• Tympanotomy: A surgical operation to expose the middle ear and
allow access to the ossicles. It is usually performed by using around
the ear drum and turning it forwards.
• Tympanoplasty: Surgical repair of tympanic membrane ( eardrum) or
surgical repair of a perforated eardrum by grafting.

22. NURSING MANAGEMENT
• Acute pain (Otalgia) related to disease condition as evidenced by
patient verbalization
• Altered auditory sensation perception related to fluid accumulation in
middle ear as evidenced by Patient unable to respond
• Knowledge deficit related to disease process and treatment as
evidenced by patient is having many doubts
• Risk for infection related to decreased immune response