Middle Ear Flashcards
What is acute otitis media (AOM)?
Acute inflammation of the middle ear often caused by the spread of a throat infection through the Eustachian tube
What causes acute otitis media (AOM)?
Viruses usually
How does acute otitis media (AOM) present?
Usually young children
Fever
Otalgia
Red inflamed tympanic membrane
How do you treat acute otitis media (AOM)?
Self limiting over 4 days
Supportive
Amoxicillin (clarithromycin) if severe
What is otitis media with effusion (OME)?
Chronic inflammation of ear resulting in fluid collection in middle ear causing conductive hearing loss
How does otitis media with effusion (OME) present?
Young children
Conductive hearing loss
Associated with
- Development/behavioural problems
- Balance problems
What does otitis media with effusion (OME) show on otoscope?
Opaque tympanic membrane
Fluid bubbles under tympanic membrane
What does otitis media with effusion (OME) show on audiometry?
Conductive hearing loss
What does otitis media with effusion (OME) show on tympanometry?
Flat tympanometry (reduced tympanic mobility from fluid)
What are some risk factors for otitis media with effusion (OME)?
Smoking household
Older siblings
Day care
URTI and immunodefiencey)
Genetic craniofacial abnormalities
How is otitis media with effusion (OME) managed?
Wait three weeks and review (90% resolve in 3 weeks)
If persisting, surgery
What are the indications and options for surgical management of otitis media with effusion (OME)?
Indicated if otitis media with effusion (OME) persisting 3 weeks after primary care assessment
If under 3
- grommets
If over 3
- grommets (first intervention)
- grommets and adenoidectomy (second intervention)
What are grommets?
Plastic tubes inserted across tympanic membrane to equalise pressure
They are eventually extruded (expelled) from tympanic membrane
What is cholesteatoma?
Abnormal growth of keratinising squamous epithelium (skin) in the middle of the ear
What two types of cholesteatoma are there?
Congenital
Acquired (from tympanic membrane perforation)
How does cholesteatoma present?
‘Cheesy’, foul smelling discharge
Conductive hearing loss
How does cholesteatoma show on otoscopy?
Crust-like lesion in upper tympanic membrane
Retraction pockets (part of eardrum lying deeper than it should be)
Pearly white mass behind tympanic membrane if congenital
How are cholesteatoma treated?
Surgical excision
What organism is associated with chronic acute otitis media (AOM)?
Pseudomonas aeruginosa
What is ossicular chain disruption?
What does it cause?
What can cause it?
Loss of normal alignment of the ossicles
Conductive hearing loss
Longitudinal temporal bone fracture
What is otosclerosis?
What does it cause?
Abnormal growth of bone near middle ear
Conductive hearing loss
