Otitis Media Flashcards
define
this is inflammation of the middle ear
define otitis media with effusion (glue ear)
this is inflammation of the inner ear with fluid behind the tympanic membrane
why does fluid in the ear need to be removed?
it increases in viscosity so needs to be removed due to increased risk of infection
what is glue ear associated with?
URTIs (perforation heals spontaneously)
eustachian tube dysfunction/obstruction
what conditions are associated with abnormally shaped eustachian tubes?
Down’s syndrome
cleft palate
what should be considered in adults with otitis media?
rhinosinusitis (same mucosa so oedema)
nasopharyngeal carcinoma
lymphoma
what increases the incidence of otitis media?
day care older siblings smoking household recurrent URTI allergies not breastfed
presentation of glue ear
children can present with speech delay or behavioural problems
have to shout loud due to hearing loss
diagnosis of glue ear
tympanogram tests middle ear function (will be flat)
retracted drum
dull colour
radiology should be black but appears grey due to presence of fluid
superior complications in glue ear
infection can erode through bone causing extradural or subdural abscess on the brain that can progress to meningitis
medial complications in glue ear
sensorineural hearing loss/ tinnitus/ vertigo/ facial palsy
posterior complications of glue ear
venous sinus thrombosis
lateral complications of glue ear
mastoid abscess that causes ear to stick out
management
remove pus (yellow > grey) watchful waiting, review at 3 months (prolong if winter as hearing usually worse) surgery
when should referral of glue ear be considered?
persistent bilateral OME (>3months) CHL >25dB speech/language problems developmental behavioural problems
surgical management for glue ear
< 3= grommets
> 3= grommets
>3 (second intervention, usually if grommets fall out)= grommets and adenoidectomy
describe a grommet
this is a stent
hole is made in the eardrum and fluid removed before the grommet is attached
complications of grommets
infection= weak blood supply so poor healing
early extrusion
retention= held onto/ fell into middle ear
persistent perforation= hole made does not close
swimming/bathing issues
what are swimming/bathing issues with grommets
hearing loss
dizzy if water enters the middle ear as cannot distinguish which way is up (drowning- earplugs as management)
