Acute Otitis Media Flashcards
What is the etiopathogenesis of acute otitis media?
- (Viral) pharyngitis
- Bacterial superinfection (strep pneumoniae/pneumococcus) from pharynx to ET
- Otitis media
What is the pathogenesis of tubal obstruction?
Edema of ET -> blockage
What is the C/F of tubal obstruction?
Retracted TM due to negative pressure in middle ear cavity
What is the pathogenesis of hyperemia/presuppuration?
Inflammation of walls of middle ear -> increased vascularity -> exudation
What is the C/F of stage of hyperemia/presuppuration?
- severe pain
- cartwheel appearance (radially running vessel on TM)
What happens in suppuration?
Pus forms in the middle ear cavity
What is the C/F of stage of suppuration?
- pressure on TM -> max pain -> TM bulges -> TM ruptures (post.) & pain relieved
- lighthouse sign = pulsatile otorrhea
What are the stages of acute otitis media?
- Tubal obstruction
- Hyperemia/presuppuration
- Suppuration
What is the management if presented with severe pain, TM red and congested, & cartwheel appearance?
Antibiotics + analgesics + decongestants
What is the management if presented with severe pain, TM red and congested, & slight bulge?
Antibiotics + analgesics + decongestants
What is the management if presented with severe pain, TM red and congested, & full and bulge (impending rupture)?
Myringotomy + antibiotics
What is the management if presented with AOM and complications (facial palsy, labyrinthitis, vertigo)?
Myringotomy
What is the site of incision in a myringotomy?
Posteroinferior quadrant
Why isn’t incision given in the posterosuperior quadrant?
Due to risk of damage to incus, incudostapedial joint, oval window & facial nerve
What is the shape of incision made in myringotomy?
Curvilinear
Why is radial incision not given in myringotomy?
Closes fast & prevents complete drainage
What is the treatment if TM is already ruptured?
Antibiotics (local & systemic) + decongestants + analgesics
- heals by 3 months
What is bullous myringitis?
AKA Myringitis bullosa/otitis external hemorrhagica
- bullous bulge on TM
What is the causative organisms of bullous myringitis?
M/C = streptococcus pneumoniae
Other = influenza virus, mycoplasma pneumoniae
What is the management for bullous myringitis?
Antibiotics
What is the M/C organism that causes acute necrotizing otitis media?
Beta-hemolytic streptococcus
What is the type of perforation seen in acute necrotizing otitis media?
Marginal (annulus eroded)
What is the complication of cute necrotizing otitis media?
Squamous chronic otitis media
