Otitis Media Flashcards
What is otitis media?
An infection of the middle ear
What structures are found in the middle ear?
Cochlea, vestibular apparatus, and nerves
How do bacteria enter the middle ear?
Via the eustachian tube
What often precedes bacterial infection of the middle ear?
Viral upper respiratory tract infection
What is the most common bacterial cause of otitis media?
Streptococcus pneumoniae
List other bacterial causes of otitis media.
- Haemophilus influenzae
- Moraxella catarrhalis
- Staphylococcus aureus
What are typical symptoms of otitis media?
- Ear pain
- Reduced hearing
- Malaise +/- fever
- URTI - cough, coryza, sore throat
- Vertigo
- Discharge (if TM perforated)
What does a normal tympanic membrane (TM) look like?
- Pearly-grey
- Translucent
- Slightly shiny
- Cone of light reflecting
What are the characteristics of otitis media during otoscopy?
- Bulging red
- Inflamed
- Discharge/hole if perforated
How do most cases of otitis media resolve?
Without antibiotics in 3 days
If no improvement at 4 days, prescribe antibiotis
What is the first-line antibiotic treatment for otitis media?
Amoxicillin (5-7 days)
Name alternative antibiotics for otitis media.
- Clarithromycin
- Erythromycin
What are potential complications of otitis media?
- Mastoiditis
- Otitis media with effusion
- Perforated TM
- Laryngitis
- Abscess
- Facial nerve palsy
- Meningitis
What is glue ear?
Otitis media with an effusion (or serious otitis media)
Common, with most children having at least one episode in childhood
Risk factors for glue ear
- male sex
- siblings with glue ear
- parental smoking
Peak age for glue ear presentations
2 years old
Features of glue ear
Hearing loss (conductive)
May result in secondary problems such as speech and language delay if persistent or chronic
How is glue ear managed?
- active observation without intervention
- grommet insertion (allows air to pass into middle ear, job normally completed by eustachian tube)
- adenoidectomy
