Otitis Media

Question 1

what is otitis media?

Answer 1

inflammation of the middle ear

Question 2

what can otitis media be associated with?

Answer 2

effusion

Question 3

what does an effusion in the middle ear risk?

Answer 3

infection

Question 4

what conditions is otitis media associated with?

Answer 4

URTIs
eustachian tube dysfunction
in adults consider rhinosinusitis (same mucosa), nasopharyngeal carcinoma and lymphoma

Question 5

what conditions have a abnormal shaped eustachian tube?

Answer 5

Down’s

cleft palate

Question 6

presentation of otitis media

Answer 6

child can present with speech delay or behavioural problems
difficulty at school
have to shout loud to hear

Question 7

diagnosis of otitis media

Answer 7

otoscope
tympanogram
imaging

Question 8

what does the otoscope show in otitis media?

Answer 8

fluid level behind the drum, retracted drum

dull colour

Question 9

imaging of the middle ear in otitis media

Answer 9

middle ear should be black due to presence of air but in OME it will be grey due to the presence of fluid

Question 10

complications of otitis media

Answer 10

• Superior: erode bone causing extradural or subdural abscess that can progress to meningitis
• Medial: sensorineural hearing loss/ tinnitus/ vertigo/ facial palsy
• Posterior: venous sinus thrombosis
• Lateral: mastoid abscess (ear sticks out)

Question 11

management of OME

Answer 11

remove pus

surgery= hearing aids, then grommets, then grommets with adenoidectomy

Question 12

where are grommets placed?

Answer 12

anteroinferior segment

Question 13

what is a grommet?

Answer 13

stent

Question 14

how is a grommet inserted?

Answer 14

hole made in the eardrum and fluid is removed before grommet is attached

Question 15

complications of grommets

Answer 15

poor healing (weak blood supply)
fall out quickly
fall into middle ear
hole does not close
hearing loss if water enters middle ear (drowning risk)

Question 16

what does eustachian tube dysfunction present with?

Answer 16

deafness
poor school performance
behaviour problems
speech delay
balance problems
TV vlume

Question 17

examination of eustachian tube dysfunction

Answer 17

TM retraction
reduced TM mobility
altered colour
CHL