Otitis Media Flashcards
What is the presentation of acute otitis media?
ear ache
bulging and red tempanic membrane
PAIN
What is acute otitis media?
URTI involving the middle ear by extension of the infection up the Eustachian tube
What commonly causes acute otitis media?
viruses
What bacteria can cause AOM?
H.influenzae
Strep pneumoniae
Strep pyogenes
How is AOM diagnosed?
clinical history
IF ear drum bursts - can swab the pus
How is AOM treated?
80% resolve in 4 days without Abx
1st line - amoxicillin
2nd line - erythromycin
What are the 3 ways to describe otitis media with effusion?
serous otitis media
glue ear
What is OME?
inflammation of the middle ear accompanied by accumulation of fluid
What is the presentation of OME?
Conductive Hearing Loss - may manifest as behavioural problems in young children
NO PAIN
balance problems
What populations are most affected by OME?
any child
M>F
day care, older siblings, smoking household, recurrent URTI
When would adults be affected by OME?
if they have eustachian tube deformities
How is OME diagnosed?
history - presistant hearing loss for a few months
Otoscopy
tuning fork tests - conductive hearing loss
audiometry - age appropriate
tympanometry
What signs of OME are seen on otoscopy?
TM retraction and reduced mobitlity
Altered TM colour
visible middle ear fluid/bubbles
What is the treatment for OME?
60% resolve in 1 month
90% resolve in 3 months
Review in 3 months and do otoscopy and tympanometry
If symptoms persist >3 months - refer to ENT
What is the necessary criteria for OME to be treated surgically?
persistant >3 months bilateral OME
CHL > 25dB
speech/language problems
developmental behaviour problems
What is the surgical management of OME for a child <3 years?
Gromit
What is the surgical management of OME for a child >3 and first intervention?
Gromit
What is the surgical management of OME for a child >3 and second intervention?
Gromit and adenoidectomy
What are the possible complications of OME?
infection discharge early extrusion dont last forever retention persistant perforation swimming/bathing issues
What do children with Downs Syndrome or cleft palate get instead of a gromit in OME?
hearing aid - they have a different anatomy of their ear
