Otitis media Flashcards
What is mucosal otitis media?
Tympanic membrane perforation on presenace of recurrent or persistent ear infection
Wet with inflamed middle ear mucosa and discharge (unless inactive)
What is mucosal otitis media?
Tympanic membrane perforation on presenace of recurrent or persistent ear infection
Wet with inflamed middle ear mucosa and discharge (unless inactive)
What is squamous otitis media?
Gross retraction of tympanic membrane forms a pocket (inactive). Keratin collection forms cholesteatoma (active)
Chronic ear discharge
What is a cholesteatoma?
an accumulation of benign keratinizing squamous cells which are hyperproliferating.
What does a choleastoma do to adjacent bone?
Erode it by producing proteolytic enzymes
Intratemporal complications of otitis media?
- Hearing loss
- Tympanic membrane perforation
- Mastoiditis
- Labyrinthitis
- Facial nerve palsy
Intracranial complciations of otitis media
- Meningitis
- Intracranial abscess
- Lateral sinus thrombosis
- Cavernous sinus thrombosis
- Subdural empyema
Treatment of chronic otitis media
If active discharge -> antibiotic and steroid drops. Self healing if dry
If fails -> surgical repair of tympanic membrane (myringoplasty)
How long do simple tympanic membraine perforations normally take to heal?
Acute otitis media, trauma, iatrogenic
3 months
If not -> myringoplasty
What is acute otitis media?
defined as the presence of inflammation in the middle ear, associated with an effusion and accompanied by the rapid onset of symptoms and signs of an ear infection
How is recurrent AOM defined?
3 + episodes in preceding 6 months OR
4 or more episodes in preceding 12 months with at least one in the last 6
Most common causes of bacterial pathogens AOM
Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Streptococcus pyogenes
Viral causes of AOM
RSV, rhinovirus, adenovirus, influenza, parainfluenzs
Why are children more likely ot get AOM than adults
shorter and more horizontal eustachian tubes
Risk factors for acute otitis media
Young age.
Male sex.
Smoking and/or passive smoking.
Frequent contact with other children such as daycare or nursery attendance or having siblings (increases exposure to viral illnesses).
Formula feeding — breastfeeding has a protective effect.
Craniofacial abnormalities (such as cleft palate).
Use of a dummy.
Prolonged bottle feeding in the supine position.
Family history of otitis media.
Lack of pneumococcal vaccination.
Gastro-oesophageal reflux.
Prematurity.
Recurrent upper respiratory tract infection.
Immunodeficiency
