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Otitis Media
Otitis Media
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otitis media

  1. 1. Presented by : Ekata karki Bsn 3rd year
  2. 2. Otitis media Otitis media is a group of inflammatory diseases of the middle ear. It is most common infection of infancy and early childhood (6 month and 2yrs of age).study have shown prevalance of it is 27% in 3-8 age group. Children are more prone due to  Short wide and horizontally positioned Eustachian tube.  Poor develop cartilage lining.  Enlarged lymphoid tissue  Position during Breast feeding (supine position)
  3. 3. Types: •Acute otitis media= <3mnth infection  Otitis media with effusion (OME)=serous discharge  Chronic otitis media=>3mnth infection
  4. 4. Acute otitis media (AOM) Acute inflammation of middle ear by pyogenic organisms. Aetiology  Especially in infant and children usually following upper respiratory tract infection  Recurrent attack of common cold  Tonsillitis  Chronic rhinitis, sinusitis  Cleft palate  Packing of nose for epistaxis
  5. 5. Clinical features:  Pain and discomfort (pull and rub infected ear)  Fever  Irritability ,restlessness ,crying, loss of appetite.  Nasal congestion , cough ,vomiting& diarrhea.  Ear discharge if perforated tympanic membrane.  Hearing impairment. Otoscopic examination  Rough, red bulging tympanic membrane.  Perforation of eardrum with discharge
  6. 6. Diagnosis  Sensitivity test ( Suction) : To suck out any discharge, confirm clinical findings and examination of the discharge for pus culture and antibiotic sensitivity.  Tuning fork tests  Treatment  Antibiotics  Analgesic and Antipyretic  Nasal decongestant- relieve Eustachian tube edema and blockage.  Local Heat application to relieve pain  Myringotomy – incision to evacuate pus from middle ear when tympanic membrane is bulging causing acute pain .
  7. 7. Otitis media with effusion(OME)  Glue ear  Inflammation of middle ear in which collection of fluid is present in its space.  May be serous , mucoid & purulent. Cause: ET tube obstruction & dysfunction (adenoids /neoplasm of nasopharaynx) URTI
  8. 8. Clinical features  Mild to moderate hearing loss  Feeling of blockage and pressure in the ear  Sign of AOM may frequently present Management  Recover spontaneously after 3 month  If exceed antibiotic therapy with myringotomy insertion of tympanotomy tube ( ventilation tube)  Amoxicillin (3-6 wks)  Precaution during Swimming
  9. 9. Chronic suppurate otitis media (CSOM)  It is recurrent and persistent ear effusion due to chronic infection  May result due to neglected AOM & more common among children with inadequate access to PHC. Organism involved are  Pseudomonas aeruginosa  E.coli  Streptococcal organism
  10. 10. Types:  Non specific CSOM  Tubo tympanic  atticoantral  Specific CSOM  Tuberculous and allergic  Tubo tympanic CSOM: If the tympanic membrane fails to heal after AOM it is tubo tympanic type It is safe type because it usually doesnot produce complication
  11. 11. Atticoantral CSOM: chronic infection of mucosa of middle ear cleft characterized by the presence of cholesteatoma. Clinical feature:  Recurrent ear discharge  Hearing loss varying degree  Perforation of TM Diagnosis:  Pus culture & sensitivity
  12. 12. Management:  Medical management:  Antibiotic: ( 7 days)  Topical antibiotics ear drops with or without steroids (7 to 10 days) Management of URTI & allergy Suction of discharge  Surgical management: Myringoplasty
  13. 13. FEATURES INDICATING COMPLICATION IN CSOM Suggestive of intracranial complications  Pain- uncommon in uncomplicated CSOM  Vertigo , Persistent Headache  Facial Weakness  Feeding refusal by child and easily going to sleep  Fever, Nausea and vomiting  Irritability and neck rigidity
  14. 14. Nursing management:  Assess the child for fever and pain and manage accordingly.  Administer prescribed medicine.  Facilitate drainage and keep external ear clean and dry.  Provide pt & family teaching.  Give instruction about precaution to be apply to prevent its reoccurrence  Prevent water from entering ea  Avoid swimming  Avoid cleaning with hair clip bud  Avoid blowing forcefully.  Avoid bottle feeding  Prompt management of acute URTI

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