Otitis media is an inflammation of the middle ear that is usually caused by bacterial or viral infections. It most commonly affects children under 15 years old. Acute otitis media lasts less than 6 weeks and is characterized by ear pain, fever, and other symptoms. Chronic otitis media lasts more than 6 weeks and can lead to permanent perforation of the eardrum. Treatment involves antibiotics, analgesics, and sometimes surgery to repair damaged tissues. Nursing care focuses on pain management, prevention of complications, and providing education to the patient and family.

1. OTITIS MEDIA
Mr.JINCE THOMAS

2. DEFINITION
• IT IS AN INFLAMMATION OF MIDDLE EAR
CHARACTERIZED BY THE
ACCUMULATION OF INFECTED FLUID IN
THE MIDDLE EAR , BULGING OF THE
EARDRUM, PAIN IN THE EAR.

4. INCIDENCE
MOST COMMON IN CHILDREN UNDER 15 YEARS OF
AGE

5. ETIOLOGY
• BACTERIA (STREPTOCOCCUS PNEUMONIAE, HAEMOPHILUS
INFLUENZA)
• UPPER RESPIRATORY INFECTION

6. PATHOPHYSIOLOGY
DUE TO ETIOLOGICAL FACTORS
EXUDATES AND EDEMA IN THE MIDDLE EAR
DECREASE RETRACTION OF TYMPANIC MEMBRANE
SEROUS EXUDATES IN MIDDLE EAR
PUS FORMATION
TYMPANIC MEMBRANE RUPTURE
ACUTE OTITIS MEDIA

7. CLASSIFICATION
1. ACUTE OTITIS MEDIA
2. CHRONIC OTITIS MEDIA
OTHER –
SUPPURATIVE OTITIS MEDIA
NON SUPPURATIVE OTITIS MEDIA

8. 1. ACUTE OTITIS MEDIA
IT IS AN ACUTE INFECTION OF
THE MIDDLE EAR, USUALLY LASTING LESS
THAN 6 WEEKS.

9. SIGNS AND SYMPTOMS
• EAR PAIN
• FEVER
• OTORRHEA ( INCREASED EAR DISCHARGE)
• RHINITIS
• HEARING LOSS
• IRRITABILITY

10. DIAGNOSIS
• HISTORY COLLECTION
• PHYSICAL EXAMINATION
• OTOSCOPIC EXAMINATION
• CULTURE AND SENSITIVITY
• AUDIOMETRY AND TYMPANOMETRY
• CT SCAN AND MRI

11. MEDICAL MANAGEMENT
 ANTIBIOTICS
 ANALGESIC
 ANTIHISTAMINE
SURGICAL MANGEMENT
• MYRINGOTOMY OR TYMPANOTOMY ( INCISION IN THE TYMPANIC
MEMBRANE)
MANAGEMENT

12. COMPLICATIONS
• CHRONIC OTITIS MEDIA
• HEARING LOSS
• PERFORATION
perforation

13. 2. CHRONICOTITIS MEDIA
DEFINITION
• INFLAMMATION OF THE MIDDLE EAR THAT LASTS FOR
MORE THAN 6 WEEKS.
OR
• IT IS ALONG STANDING INFECTION OF THE MIDDLE EAR
CHARACTERIZED BY EAR DISCHARGE AND PERMANENT
PERFORATION

14. ETIOLOGY
• INAPPROPRIATE TREATMENT OF ACUTE OTITIS MEDIA
• URTI, ALLERGIC RHINITIS
• EUSTACHIAN TUBE DEFORMITY
• SEPTAL DEVIATION, CLEFT PALATE, SINUSITIS

15. 1. SUPPURATIVE (+ PERFORATION)
a. ATICO-ANTRAL CHRONIC OTITIS MEDIA
INFLAMMATION INVOLVES BONES ( MASTOID,TYMPANIC RING,
OSSICLES).
b. TUBO- TYMPANIC OTITIS MEDIA
OTITIS MEDIA PERMANENT PERFORATION
MUCO-PURULENT DISCHARGE.

16. 2. NON SUPPURATIVE
STAGES
 URTI OR OTITIS MEDIA FLUID COLLECTION IN
MIDDLE EAR AND OBSTRUCTION OF EUSTACHIAN TUBE
TYMPANIC MEMBRANE RETRACTION.
 FLUID BECOMES PUS LIKE NECROSIS TYMPANIC
MEMBRANE PERFORATION.
 COULD END UP WITH MASTOIDITIS ( IF NOT TREATED).

17. CLINICAL MANIFESTATIONS
• HEARING LOSS
• OTORRHEA
• TINNITUS

18. MANAGEMENT
MEDICAL MANAGEMENT
INSTILLATION OF ANTIBIOTIC DROPS
CAREFUL SUCTIONING OF THE EAR UNDER MICROSCOPIC
GUIDANCE.
SURGICAL MANAGEMENT
TYMPANOPLASTY( SURGICAL RECONSTRUCTION OF THE
PERFORATED TYMPANIC MEMBRANE)
OSSICULOPLASTY ( SURGICAL RECONSTRUCTION OF THE
MIDDLE EAR BONES TO RESTORE HEARING)
MASTOIDECTOMY ( SURGICAL REMOVAL OF THE DISEASED
MASTOID BONE)

19. NURSING MANAGEMENT
COLLECT HEALTH HISTORY INCLUDES A COMPLETE DESCRIPTION
OF THE EAR PROBLEM.
COLLECT DATA ABOUT THE DURATION AND INTENSITY OF THE
PROBLEM, ITS CAUSES AND PREVIOUS TREATMENTS.
OBTAIN INFORMATION ABOUT OTHER HEALTH PROBLEMS AND
MEDICATIONS
PHYSICAL ASSESSMENT INCLUDES OBSERVATION FOR ERYTHEMA,
EDEMA, OTORRHEA, LESIONS AND CHARACTERISTICS SUCH AS
ODOR AND COLOUR OF DISCHARGE.

20. CONT…..
TEACH THE PATIENT TO KEEP THE EAR DRY.
AVOID WASHING HAIRS AND SWIMMING
REDUCE THE ANXIETY OF THE PATIENT.
PROVIDE PSYCHOLOGICAL SUPPORT.
PREVENT FURTHER COMPLICATIONS .

21. PAIN R/T INFECTION
RISK FOR INFECTION R/T EUSTACHIAN TUBE DYSFUNCTION
ALTERED AUDITORY SENSORY PERCEPTION R/T FLUID IN THE MIDDLE
EAR
ANXIETY R/T SURGICAL PROCEDURES , POTENTIAL LOSS OF HEARING
RISK FOR TRAUMA R/T BALANCE DIFFICULTIES OR VERTIGO DURING
THE IMMEDIATE POSTOPERATIVE PERIOD.
KNOWLEDGE DEFICIT R/T DISEASE, SURGICAL PROCEDURE AND
POSTOPERATIVE CARE.
NURSING DIAGNOSIS