acute otitis media

Question 1

what is acute otitis media ?

Answer 1

acute inflammation of the lining of the middle ear

Question 2

what is the most common age group affected with otitis media ?

Answer 2

infancy

Question 3

what is the lining of the middle ear ?

Answer 3

non keratinized squamous epithelium

Question 4

what is the eustachian tube ?

Answer 4

tube that connects the middle ear with the nasopharynx
allows for the equalization of pressure on both sides of the tympanic membrane

Question 5

what are the riskk factors associated with acute otitis media ?

Answer 5

overcrowding
exposure to smoking
attending nursery or day care
age 6-18 months

Question 6

what are the causes of acute otitis media ?

Answer 6

URTI
viral infections
bacterial infections

Question 7

what are the bacterial organisms causing acute otitis media?

Answer 7

moraxella catarrhalis
haemophilus influenza
strep pneumoniae

Question 8

what are the pathological stages of acute otitis media ?

Answer 8

1. eustachian tube obstruction- congestion and oedema
   2.acute catarrhal otitis media
2. stage of suppuration
3. stage of perforation

Question 9

what are the changes that occur during the acute catarrhal stage of otitis media ?

Answer 9

congestion and oedema of the middle ear mucosa with serous exudation

Question 10

what are the changes that happen during the stage of suppuration ?

Answer 10

the exudate becomes mucopurulent and pus accumulates under tension

Question 11

what are the changes that happen during the stage of perforation ?

Answer 11

necrosis of the drum causes perforation

Question 12

what are the symptoms of acute otitis media in infants ?

Answer 12

fever
ear pulling
irritability
vomiting

Question 13

what are the symptoms of acute otitis media in older patients ?

Answer 13

otalgia
fever
generally unwell
hearing loss +/- tinnitus

Question 14

what is purulent discharge associated with in acute otitis media ?

Answer 14

if the TM ruptures ( released the abscess in the middle ear) it is associated with an improvement of symptoms

Question 15

what are the signs of acute otitis media ?

Answer 15

injected TM
Bulging TM
Purulent discharge and TM perforation
a secondary complication may be otitis externa

Question 16

what are the complications of AOM ?

Answer 16

mastoiditis
TM perforation
facial nerve paralysis
intracranial complications

Question 17

what are the investigations for AOM ?

Answer 17

swab for culture and sensitivity
CT scan of temporal bone if complications are suspected

Question 18

what is the medical treatment for AOM ?

Answer 18

rest, fluids
analgesics, antipyretics
antibiotics
nasal decongestants

Question 19

what is the surgical management for AOM ?

Answer 19

myringotomy

Question 20

what are the indications for a myringotomy ?

Answer 20

Bulging TM
failure of medical treatment within 48 hours
if TM already ruptured : if the perforation is very small to drain or too high

Question 21

what is the prognosis of AOM ?

Answer 21

either :
complete resolution with healing of TM
or
Chronicity of TM perforation: becomes mucosal CSOM which is also known as chronic otitis media

Question 22

what are the reed flags associated with AOM ?

Answer 22

facial nerve paralysis
mastoid swelling
headache and deterioration of general condition