2. EAR DISEASES: Diseases of the External Ear Otitis Media and Middle Ear Effusions Chronic Otitis Media Otosclerosis Meniere’s Disease Deafness
3. Diseases of the External Ear The external ear is composed of the auricle, the external auditory canal (EAC), and the epithelial surface of the tympanic membrane Trauma, infections ,neoplasms
4.
5.
6.
7. INFECTION AND INFLAMMATION OF THE EXTERNAL EAR AURICLE Cellulitis of the Auricle: Cellulitis is a bacterial infection that usually follows abrasion, laceration Allergic Dermatitis of the Auricle: Allergic dermatitis of the auricle is haracterized by localized erythema, swelling, and itching in the area of allergen exposure. EXTERNAL AUDITORY CANAL Acute Localized Otitis Externa (Furuncle) Acute Diffuse Otitis Externa (Swimmer’s Ear) Chronic Otitis Externa Necrotizing (Malignant) External Otitis Fungal Otitis Externa (Otomycosis)
8.
9. Otitis Media and Otitis Media with Effusions Synonyms Used in the Past for Otitis Media Acute Otitis Media Otitis Media with Effusion Suppurative Serous Purulent Secretory Bacterial Mucoid Glue ear Middle ear effusion DEFINITIONS: Otitis media represents an inflammatory condition of the middle ear space, without reference to cause or pathogenesis. Middle ear effusion is the liquid resulting from OM.An effusion may be either serous (thin, watery), mucoid (viscid, thick), or purulent (pus). The process may be acute (0 to 3 weeks in duration ), subacute(3 to 12 weeks in duration) , or chronic (greater than 12 weeks in duration ).
Trauma to the external ear is common in all age groups. The unprotected auricle is at risk for all kinds of trauma including cold or hot thermal injury and blunt or sharp injury resulting in ecchymosis, hematoma, laceration, or fracture.
Unfortunately, numerous terms have been used to describe the various inflammatory conditions of the middle ear space (Table). This has resulted in both confusion and a lack of uniformity in reporting.An attempt to standardize nomenclature was undertaken in the early 1980s and will be used throughout this chapter when discussing this disease process This chapter deals primarily with two disease processes: acute otitis media (AOM) and chronic otitis media with effusion (COME).
Eustachian tube (ET) dysfunction is considered the major etiologic factor in the development of middle ear disease. Why a higher incidence of acute otitis media occurs in children?
These usually include otalgia, fever, irritability, anorexia, vomiting, diarrhea, or otorrhea
Physical examination usually reveals a thickened, erythematous or bulging tympanic membrane with limited or no mobility to pneumatic otoscopy. Erythema:It caused by dilatation and congestion of the capillaries
Oral decongestants may relieve nasal congestion, providing some aeration of the ET. Their efficacy has not been proven, however.
The tympanic membrane may present numerous physical findings including thickening, opacification, and impaired mobility. An air-fluid level and/or bubbles may be observed through a translucent tympanic membrane. This entity is distinguished from AOM in that the signs and symptoms of acute infection are lacking (eg, otalgia, fever, otorrhea).
