Otitis Media

Question 1

What is otitis media?

Answer 1

Infection of the middle ear

Question 2

What are the common causative organisms?

Answer 2

• Strep pneumoniae
• H. influenza
• Moraxella

Question 3

What is the presentation of otitis media?

Answer 3

*Otalgia
>which resolves suddenly with the perforation of the drum
*Discharge upon drum perforation
*Conductive hearing loss which improves with perforation
*Fever
*Associated cough and nasal discharge (URTI proceeds)
*Children may simply tug/pull on ear
*Typanic membrane = bulging, erythema, and no longer translucent

Question 4

What investigations needed?

Answer 4

• Clinical diagnosis from Hx and looking at ear

* no further investigations needed unless septic/mastoiditis

Question 5

What are the complications?

Answer 5

• perfroation
• mastoiditis
• meningitis

Question 6

What is the manageement?

Answer 6

• Analgesia -paracetamol/NSAID
• Antibiotics not always needed as usually resolve spontaneously
• Antibiotics if not resolving give amoxicillin

Question 7

What is the presentation of otitis media with effusuion?

Answer 7

• Feeling of fullness in ear
• hearing loss (conductive)
• balance issues
• polar speech and language development/socially withdrawn in children
• tympanic membrane may be normal but may be abnormal

Question 8

What is the investigation of OM with effusion?

Answer 8

*Pneumatic otoscopy used to diagnose =tympanic membrane won’t move =flat trace

Question 9

What is the management of OM with effusion?

Answer 9

• watch and wait until spontaneously resolve 6-12week
• refer to ENT
• persistant = gromets

Question 10

When are antibiotics given for OM?

Answer 10

• Sever cases that don’t resolve after 4-5days
• Under the age of 2 and bilateral
• Systemically unwell but don’t require admission