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Otitis media

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Otitis media is a group of inflammatory diseases of the middle ear. The two main types are acute otitis media (AOM) and otitis media with effusion (OME). AOM is an infection of rapid onset that usually presents with ear pain.

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Otitis media

  1. 1. Otitis media Presented By: Mr. Abhay Rajpoot
  2. 2. INTRODUCTION • An ear infection (sometimes called acute otitis media) is an infection of the middle ear, the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear. Children are more likely than adults to get ear infections
  3. 3. DEFINITION It is accumulation of the fluid in middle ear, the space between tympanic membrane and inner ear. The middle ear is usually filled with air but sometimes get filled with mucus and fluid. Some time this mucus can get infracted sometimes with pathogens called an ear infection. It is most common paediatric problem.
  4. 4. RISK FACTORS • Age. Children between the ages of 6 months and 2 years are more susceptible to ear infections because of the size and shape of their eustachian tubes and because their immune systems are still developing. • Group child care. Children cared for in group settings are more likely to get colds and ear infections than are children who stay home. The children in group settings are exposed to more infections, such as the common cold. • Infant feeding. Babies who drink from a bottle, especially while lying down, tend to have more ear infections than do babies who are breast- fed.
  5. 5. CONTI… • Seasonal factors. Ear infections are most common during the fall and winter. People with seasonal allergies may have a greater risk of ear infections when pollen counts are high. • Poor air quality. Exposure to tobacco smoke or high levels of air pollution can increase the risk of ear infections. • Alaska Native heritage. Ear infections are more common among Alaska Natives. • Cleft palate. Differences in the bone structure and muscles in children who have cleft palates may make it more difficult for the eustachian tube to drain.
  6. 6. AETIOLOGY • Bacteria (Streptococcus pneumonia) • Virus • URI (Upper respiratory tract infection) Ex. Sinsuitis • Allergic reaction • Inadequate treatment of acute otitis media
  7. 7. CLINICAL MANIFESTATIONS Children • Ear pain, especially when lying down • Tugging or pulling at an ear • Trouble sleeping • Crying more than usual • Fussiness • Trouble hearing or responding to sounds • Loss of balance
  8. 8. CONTI… • Fever of 100 F (38 C) or higher • Drainage of fluid from the ear • Headache • Loss of appetite
  9. 9. CONTI… Adults • Ear pain • Drainage of fluid from the ear • Trouble hearing
  10. 10. DIAGNOSTIC EVALUATION • History Collection • Physical examination • Tympanometry. This test measures the movement of the eardrum. The device, which seals off the ear canal, adjusts air pressure in the canal, which causes the eardrum to move. The device measures how well the eardrum moves and provides an indirect measure of pressure within the middle ear. • Acoustic reflectometry. This test measures how much sound is reflected back from the eardrum — an indirect measure of fluids in the middle ear. Normally, the eardrum absorbs most of the sound. However, the more pressure there is from fluid in the middle ear, the more sound the eardrum will reflect. • Tympanocentesis. Rarely, a doctor may use a tiny tube that pierces the eardrum to drain fluid from the middle ear — a procedure called tympanocentesis. The fluid is tested for viruses and bacteria. This can be helpful if an infection hasn't responded well to previous treatments
  11. 11. COMPLICATIONS • Impaired hearing. • Speech or developmental delays. • Spread of infection • Tearing of the eardrum.
  12. 12. PREVENTION • Prevent common colds and other illnesses. • Avoid secondhand smoke. • Breast-feed baby. • While bottle-feeding, hold baby in an upright position.
  13. 13. MANAGEMENT Antibiotic therapy • After an initial observation period, your doctor may recommend antibiotic treatment for an ear infection in the following situations: • Children 6 months and older with moderate to severe ear pain in one or both ears for at least 48 hours or a temperature of 102.2 F (39 C) or higher • Children 6 to 23 months with mild middle ear pain in one or both ears for less than 48 hours and a temperature less than 102.2 F (39 C) • Children 24 months and older with mild middle ear pain in one or both ears for less than 48 hours and a temperature less than 102.2 F (39 C)
  14. 14. CONTI….. • Pain medication (Analgesics Drug) • Broad Spectrum antibiotic therapy ( Penicillin) • NSAIDs Drugs
  15. 15. SURGICAL MANAGEMENT: • Myringotomy: incision through eardrum to create an artificial opening either to allow infected fluid to drain from the middle ear in acute otitis media • Tympanotomy: A surgical operation to expose the middle ear and allow access to the ossicles. It is usually performed by using around the ear drum and turning it forwards. • Tympanoplasty: Surgical repair of tympanic membrane ( eardrum) or surgical repair of a perforated eardrum by grafting.
  16. 16. NURSING MANAGEMENT • Acute pain (Otalgia) related to disease condition as evidenced by patient verbalization • Altered auditory sensation perception related to fluid accumulation in middle ear as evidenced by Patient unable to respond • Knowledge deficit related to disease process and treatment as evidenced by patient is having many doubts • Risk for infection related to decreased immune response