DT Otitis Media

OTITIS MEDIA
ADINDA HARI UTARY

I 406 1171 005
DEFINITION
 The inflammation of the mucous membrane of the middle ear
cleft
 May also involve inflammation of the mastoid, petrous apex,
perilabyrinthine air cells
EPIDEMIOLOGY
 Global health care problem most commonly seen in the pediatric
population
 The majority of children will be diagnosed at least one episode of
AOM with rates of incidence peaking at age 2
 OM does present in the adolescent and adult population (3% -
15%)
CLASSIFICATION
Otitis Media
Acute Chronic
rapid onset of sign & symptoms,

12 weeks or longer
< 12 weeks
Acute Otitis Media
 Acute inflammation in middle ear by pyogenic organisms (Streptococcus
hemolitikus, Staphylococcus aureus, Pneumococcus, Haemophillus influenza,
E.coli, Proteus vulgaris)
Aetiology
 Upper respiratory tract infection (infant and children)

 Recurrent attack of common cold
 Tonsilitis
 Chronic rhinosinusitis
 Cleft palate
Acute Otitis Media
Clinical Features
 Stage of tubal occlusion
 Stage of hyperemia
 Stage of suppuration
 Stage of resolution
 Stage of complication
Acute Otitis Media
Signs and Symptoms
 Pain and discomfort (pull and rub infected ear)
 Fever
 Irritability, restlessness, crying, loss of appetite
 Nasal congestion, cough, vomiting, diarrhea
 Hearing impairment
 Ear discharge
Acute Otitis Media
Treatment
 Medical management
 Antibiotic
 Analgesic
 Surgical Management
 Myringotomy or tympanotomy
Chronic Suppurative Otitis Media
 Chronic infection of mucoperiosteal lining of the middle ear cleft
 Accompanied by continuous or intermittent otorrhea
Classification
 Safe / benign / tubotympanic type
 Dangerous / malignant / attico-antral type
Variable Benign Type Dangerous Type
Site Tubotympanic Atticoantral
Perforation Central Attic or Marginal
Discharge • Intermittent • Continuous
• Mucupurulent/purulent • Purulent
• Without foul smell • Foul smelling
• White/yellowish • Yellowish/brownish
• Bleeding uncommon • Bleeding possible
• More with URTI • No effect of URTI
Deafness Conductive, Conductive,

mild to moderate mild to severe
Complications Very rare Common
Cholesteatoma Very rare Almost always present
Signs
 Perforation (both type)
 Tenderness over the mastoid (due to mastoiditis)
Central Marginal
Perforation Perforation
Symptoms
 Otorrhea
 Deafness
 Tinnitus
 Giddiness (due to labyrinthitis)
 Swelling in the mastoid region due to mastoid abscess
-diagnosis-
 Examination of nose and pharynx to find any septic focus or an

obstruction around the eustachian tube
 Hearing test
 Radiology of the mastoid
 Testing the patency of eustachian tube
 Otomicroscopy
Treatment
 Conservative Treatment
 Removal of septic foci like adenoids, tonsils, sinusitis

 Aural toilet: prevention of entry of water into the ear; cleaning of the ear with a dry swab
stick or suction.
 Good nutrition
 Improvement of general condition
 Surgical Treatment
 Adenoidectomy, septoplasty, myringoplasty, tympanoplasty

-complications-
Extracranial Intracranial
 Petrositis  Extradural abscess
 Facial nerve palsy  Subdural abscess
 Labyrinthitis  Meningitis
 Sigmoid sinus
thrombophlebitis
 Brain abscess
Chronic Non-Suppurative Otitis Media
Synonyms
 Secretory otitis media
 Serous otitis media
 Otitis media with effusion
 Glue ear
Definition
The accumulation of non-inflammatory exudate in the middle ear

cavity following a series of pathological changed in the mucous
membrane of the middle ear.
Aetiology
Tubal occlusion; allergy: hypogammaglobulinemia

Symptoms
 Blocking sensation of the ears
 Deafness – conductive type
 Wooly feelings in the ear
 Autophony
Signs
 Tympanic membrane appears dull and lusterless but may
occasionally appears congested in the initial stage
 Retraction of the tympanic membrane
 Evidance of fluid in the middle ear in which the fluid level may
be seen as an air bubble
 Mobility of the tympanic membrane is decreased
Treatment
 Prevention of the secretory otitis media
 Removal of the possible cause
 Anti allergy
 Myringotomy with the grommet insertion
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DT Otitis Media

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OTITIS MEDIA

ADINDA HARI UTARY

rapid onset of sign & symptoms,

 Upper respiratory tract infection (infant and children)

Deafness Conductive, Conductive,

 Examination of nose and pharynx to find any septic focus or an

 Removal of septic foci like adenoids, tonsils, sinusitis

 Adenoidectomy, septoplasty, myringoplasty, tympanoplasty

The accumulation of non-inflammatory exudate in the middle ear

Tubal occlusion; allergy: hypogammaglobulinemia

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