Lecture 17 Otitis Media Flashcards
What is the most common diagnosis made in sick children in the US?
otitis media (OM)
What time of year is OM most prevalent?
winter/early spring
what kind of epithelium is seen in the eustachian tube and middle ear?
respiratory epithelium
ie pseudostratified ciliated columnar epithelium with goblet cells
Is the eustachian tube at a steeper or shallower angle in kids relative to adults? Why does this matter?
shallower –> less drainage, so more risk of infection
What is OME?
otitis media effusion;
chronic, non-infectious form of OM
Besides virsuses, what are the 3 most common causes of OM?
strep pneumo, H-flu, moraxella catarhallis
“popping ears” pulls on the ____ muscle, opening the eustachian tube
tensor veli palatini
what sort of infection is OM often a sequelae of ?
upper respiratory infection
what should you save for the last part of the physical exam in patients with OM?
throat (kids aren’t fans of tongue depressors)
Acute OM tympanic membrane (TM) triad of symptoms:
bulging, immobile, red
what should you suspect if a patient presents with fever and ear ache?
strep pneumo
what should you suspect if a patient presents with TM perforation or mastoiditis?
group A strep
What should you suspect if a patient presents with OM and conjunctivitis or bilateral OM?
H-flu
normal TM is described as having what color?
pearly gray
a swollen external auditory meatus is indicative of what?
acute otitis externa (eg swimmer’s ear)
when there is ____ pressure in the middle ear cavity, the TM is retracted (ie chronic OME)
negative
drug of choice for treating Acute OM?
amoxicillin
most common complication of OM
hearing loss
_____ is characterized by dense calcification and excessive scarring and fibrosis of the TM
Tympanosclerosis
chronic purulent drainage, white mass behind the ear drum –> indicative of _____
cholesteatoma
what do tympanograms measure?
middle-ear pressure
Deep tymanograms are characteristic of _____ compliance, such as in ossicular chain discontinuity
increased
shallow tympanograms show decreased compliance, suggesting a stiff middle ear system. What might cause this finding?
tympanosclerosis
