Conductive Deafness Flashcards
Treatment of otitis media with effusion
high spontaneous resolution rate
Re-evaluate child after 3 months
50% will still have glue present
Features of Otitis Media with effusion
Sterile collection of fluid in the middle ear Shows a flat tympanogram Fluid containsmucus and glycoproteins Can follow URTI Common in children
What is a grommet?
Tympanotomy tube that aerates middle ear
NOT DRAINS
How long for grommet to drop out?
9 months
What reduces risk of OME recurrence?
Adenoidectomy
What is Acute suppurative otitis media?
Bacterial infection of middle ear Forms pus Eardrum inflames and bulges OUTWARDS Pus and blood drain into external auditory meatus Eardrum heals in 4-5 days
Causes of ASOM?
HIB
Pneumococci
Treatment of ASOM?
Amoxicillin
Clavulonic acid
Myringotomy
With inadequate treatment can get brain abscess
What is a cholestetoma?
Disease of deep meatal skin
Skin protrudes into middle ear forming bag containing keratin
Bag gets bigger with more keratin production
Anaerobic bacteria grow to form foul smelling discharge
What is tympanosclerosis?
Calcification of collagenous scar tissue, after previous infection/trauma.
Can cause >50db deafness
What is otosclerosis?
Familial
Mendelian dominant with incomplete penetration
Spongy bone formation around oval window that grows + fuses with the stapes.
Treatment of otosclerosis?
Either
Stampedectomy
Hearing aid with prosthesis
Features of chronic suppurative otitis media
Disease of the middle ear mucosa Gets repeatedly infected Leads to micro abscesses and inflammatory cell infiltrate May get perforation ODOURLESS chronic discharge
Conductive deafness
Where can choleseatoma erode through?
ossicles Laterak semicircular canal Facial nerve canal Cochlea Tegmen Sigmoid sinus
What are retraction pockets?
Indrawing of the tympanic membrane
Self cleansing
debris accumulates to form choleasteatoma
What is tympanosclerosis?
Calcification of collagenos after previous infection
Can cause deafness
What is OTOSCLEROSIS?
Spongy bone formation causing stapes fusion
TREATMENT
Stapedectomy
Hearding aid with prosthesis
What is chronic suppurative otitis media?
Disease of middle ear mucosa Due to repeated infection, causing hypertrophy and hypersecretion May get perforation Odourless chronic discharge Conductive deafness
Treatment of chronic suppurative otitis media?
Myringoplasty
What is chronic dry perforations?
Due to childhood infections
Dont need to treat unless deafness, preventing admission to job
Treat with surgery- myringoplasty
SIgns of haemotympanum?
Blood in middle ear
Drum looks dark red or blue
May be lacerated
Conductive loss of >30db
Should you intervene with haemotympanum?
NO?
