complications of otitis media

Question 1

what are the complications of otitis media broadly divided into ?

Answer 1

intracranial complications

cranial complications

Question 2

what are the cranial complications associated with otitis media ?

Answer 2

mastoiditis
facial berve paralysis
petrositis
labrynthitis

Question 3

what are the intracranial complications associated with otitis media ?

Answer 3

meningitis
brain abscess
extradural/subdural abscess
lateral sinus thrombosis
cavernous sinus thrombosis

Question 4

what is the aetiology associated with these complications ?

Answer 4

acute otitis media
mucosal chronic otitis media
cholesteatoma

Question 5

what are the routes of spread ?

Answer 5

direct extension
blood bone
preformed pathways: congenital dehiscence
natural
surgical defect

Question 6

what is mastoiditis ?

Answer 6

acute inflammation of the mucosal lining of the mastoid cells

Question 7

what is the clinical picture associated with mastoiditis ?

Answer 7

fever, headache
hearing loss, otalgia
discharge could be present
tender postauricular swelling
lateral displacement of the pinna
may be fluctuant

Question 8

what is seen on otoscopy in cases of mastoiditis ?

Answer 8

congested or perforated TM
mucopurulent diffuse discharge that rapidly reaccumulated after suction ( reservoir sign)
sagging of the posterosuperior meatal wall

Question 9

what investigations would be required for mastoiditis ?

Answer 9

swab of EAC
CT scan of temporal bone

Question 10

what is the treatment for mastoiditis ?

Answer 10

systemic antibiotics
if no improvement after 48 hours then perform a mastoidectomy
if there is a mastoid abscess then a mastoidectomy under ab cover should be performed

Question 11

what is the aetiology of facial nerve paralysis ?

Answer 11

acute otitis media with dehiscence of the facial canal
cholesteatoma eroding the facial nerve

Question 12

what is petrositis ?

Answer 12

inflammation of the lining of the petrous apex air cells which occurs through direct extension from the mastoid air cells

Question 13

what group of people are more likley to acquire petrositis ?

Answer 13

occurs in immunocompromised patients

Question 14

what is thee clinical picture of petrositis ?

Answer 14

same picture as otitis media with retro orbital pain , abducens nerve paralysis

Question 15

what is Gradenigo syndrome ?

Answer 15

the triad of :
acute otitis media
abducent nerve paralysis ( failure to abduct eye as well as diplopia)
retro orbital pain

Question 16

what is the treatment for peetrositis ?

Answer 16

medical treatment
mastoidectomy with petrous apicectomy

Question 17

what is labrynthitis ?

Answer 17

inflammation of the inner ear

Question 18

what is the presentation of labrynthitis ?

Answer 18

vertigo
nausea and vomiting
nystagmus
sensorineural hearing loss or mixed HL

Question 19

what is the presentation of meningitis as one of the intracranial complications ?

Answer 19

fever
neck pain
phoyophobia

Question 20

what is the presentation of a brain abscess ?

Answer 20

fever
possibly seizures or focal neeurological signs
headache

Question 21

what are thee signs of ann extradural abscess ?

Answer 21

fever
ipsilateral temporal headache
pulsatile ear discharge

Question 22

what is the preseentation of otitic hydrocephalus ?

Answer 22

headache
signs of increased intracranial pressure in the setting of otitis media

Question 23

what is the presentation of sigmoid sinus thrombosis ?

Answer 23

spiking fever
otitis media
oedema and tenderness over mastoid process
headache

Question 24

what is the clinical picture associate with facial nerve palsy ?

Answer 24

loss of forehead corrugations
inability to wrinkle eyebrows
loss of nasolabial folds
inability to puff cheeks
drooping of the angle of thee mouth