Otitis media Flashcards
cause of Tympanic membrane perforation?
Recurrent otitis media (as the pus in the middle ear bulges on the tympanic membrane)
which part of the tympanic membrane forms most of the TM
pars tensa
Otoscopy findings in tympanic membrane perforation
Tympanosclerosis
what is Tympanosclerosis
Calcium deposition within the tympanic membrane due to healing from previous ear infections
how long will a perforated tympanic membrane usually take to heal?
6-8 weeks
what should a patient with tympanic membrane perforation avoid whilst healing
getting water in their ear
management of perforated tympanic membrane if it occurs following an episode of acute otitis externa
Topical abx + steroids for 7-10 days
surgical management for a perforated tympanic membrane
Myringoplasty
3 types of Otitis media?
1) Acute suppurative otitis media
2) Chronic suppurative otitis media
3) Otitis media w/ effusion
what is the commonest cause of severe aural pain in children?
Acute suppurative otitis media
what is recurrent otitis media defined as?
> 4 episodes over a 6 month period
Presentation of otitis media (6)
- mucopurulent discharge (when the tympanic membrane perforates)
- otaligia
- irritability
- sleep disturbance
- reduced hearing
- fever
otitis media is a common complication of what?
viral respiratory illness
why is otitis media associated with viral resp illness?
Upper resp viruses can interfere with nasal passages + eustachian tube
how is otitis media diagnosed?
otoscopy
otoscopy findings in otitis media
- bulging, opacified tympanic membrane, with decreased/absent mobility
- ear effusions
3 common causative bacteria of otitis media?
Streptococcus pneumoniae
Haemophilus Influenza
Moraxella Catarrhalis
Abx should be prescribed immediately for otitis media if:
- Symptoms last > 4days
- Systemically unwell
- Immunocompromised or high risk of complications
- Younger than 2 years old with bilateral otitis media
- Otitis media w/ perforation and/or discharge in the canal
1st line management of Otitis media?
5 day course Amoxicillin
+
decongestant spray = oltravine
1st line management of otitis media if allergic to penicillin?
- erythromycin
or - clarithromycin
+
decongestant spray = oltravine
if patient with otitis media is unresponsive to Abx or in severe pain …
Tympanocentesis
2 types of chronic suppurative otitis media ?
Active - w/ discharge
Inactive - w/o/ discharge
what is Active Squamous Chronic suppurative otitis media characterised by?
Cholesteatoma, due to accumulation of keratin
features of Active Squamous Chronic suppurative otitis media? (3)
- cholesteatoma
- otorrhoea
- deafness
management following perforation?
important to keep the ear dry to prevent infection due to perforation: cotton wool + petroleum jelly
simple pars tensa perforation management?
non operative or myringoplasty
simple pars flaccida perforation management?
Radical mastoidectomy
common causative organisms of chronic suppurative otitis media?
Pseudomonas Aeurginosa
Staph aureus
Streptoccus
Anaerobic - peptostreptococcus
4 intra temporal complications of Chronic Otitis Media
- vertigo
- hearing loss
- acute otitis externa
- facial weakness
4 extra temporal complications of Chronic Otitis Media
- meningitis
- subdural abscess
- temporal lobe abscess
- sigmoid sinus thrombosis
age group for Cholesteatoma?
10-20 year olds
presentation of Cholesteatoma?
- intermittent offensive smelling discharge
- long history of discharge
- hearing loss
- occasional vertigo
cause of cholesteatoma?
recurrent otitis media
