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OOttiittiiss MMeeddiiaa 
FFeerrdduusshhii AAkkhhtteerr 
JJuunniioorr FFaaccuullttyy 
PPrriimmee BBaannkk NNuurrssiinngg IInnssttiittuuttee 
11/13/14 1
Otitis media: 
Background: 
Otitis media (OM) is the second most 
common disease of childhood, after 
upper respiratory infection (URI). 
Definition: 
It is defined as an inflammation of the 
middle ear.
11/13/14 4
Classification of otitis media 
Acute otitis media 
2. Chronic otitis media 
Other-a. 
Serous otitis media 
b.Secretory otitis media 
c.Suppurative otitis media 
11/13/14 5
Otitis media 
• Healthy 
Tympanic 
Membrane
Etiology 
Age: Common among 
children due to shorter 
Eustachian tube 
11/13/14 7
Etiology 
Tonsillitis, Rhinitis, 
Sinusitis, Pharyngitis & 
infections secondary to 
cleft palate 
Trauma to the TM 
Head injury 
11/13/14 8
Clinical manifestation 
Fullness or heaviness in the ear 
Severe ear pain at night 
Deafness 
Tinnitus (ringing or buzzing in the 
ear) 
Autophony (spoken words of 
patient echo in his ears) 
11/13/14 9
Serous 
Acute otitis 
Serous otitis media media 
11/13/14 11
Perforation 
11/13/14 12
Bulging Ear drum 
11/13/14 13
Diagnostic evaluation 
• History 
• Physical examination 
• Otoscopic examination 
• Culture 
• Audiometry ( testing of the 
hearing sense) & Tympanometry 
(evaluation of the mobility and 
patency of the eardrum) 
11/13/14 14
Management 
Medical Management- 
• Administration of 
antibiotic (Ampicillin or 
Amoxicillin). 
• Anti-inflammatory 
(analgesic & antipyretic). 
11/13/14 16
Management 
Surgical management- 
Myringotomy or 
tympanotomy (incision in 
the tympanic membrane) 
11/13/14 17
Nursing care 
• Apply hot water bag over the ear with the 
child lying on the affected side may 
reduce the discomfort (applied during the 
attack of pain). 
• Put ice bag over the affected ear may also 
be beneficial to reduce edema (between 
pain attacks). 
• For drained ear; the external canal may be 
frequently cleaned using sterile cotton 
swabs (dry or soaked in hydrogen 
peroxide).
• Excoriation of the outer ear should be 
prevented by frequent cleansing & 
application of zinc oxide to the area of 
oxidate. 
• Give special attention to th tympanostomy 
tube i.e., avoid water entering the middle 
ear and introducing bacteria. 
• Educate family about care of child, & keep 
them aware with the complications of 
acute otitis media e.g.,hearing loss. 
• Provide emotional support to the child & 
his family.
Complications of O.M 
• Hearing loss 
• Chronic suppurative O.M 
• Adhesive otitis 
• Facial palsy 
• Brain abscess. 
• Meningitis.
Otitis media

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Otitis media

  • 1. OOttiittiiss MMeeddiiaa FFeerrdduusshhii AAkkhhtteerr JJuunniioorr FFaaccuullttyy PPrriimmee BBaannkk NNuurrssiinngg IInnssttiittuuttee 11/13/14 1
  • 2.
  • 3. Otitis media: Background: Otitis media (OM) is the second most common disease of childhood, after upper respiratory infection (URI). Definition: It is defined as an inflammation of the middle ear.
  • 5. Classification of otitis media Acute otitis media 2. Chronic otitis media Other-a. Serous otitis media b.Secretory otitis media c.Suppurative otitis media 11/13/14 5
  • 6. Otitis media • Healthy Tympanic Membrane
  • 7. Etiology Age: Common among children due to shorter Eustachian tube 11/13/14 7
  • 8. Etiology Tonsillitis, Rhinitis, Sinusitis, Pharyngitis & infections secondary to cleft palate Trauma to the TM Head injury 11/13/14 8
  • 9. Clinical manifestation Fullness or heaviness in the ear Severe ear pain at night Deafness Tinnitus (ringing or buzzing in the ear) Autophony (spoken words of patient echo in his ears) 11/13/14 9
  • 10.
  • 11. Serous Acute otitis Serous otitis media media 11/13/14 11
  • 13. Bulging Ear drum 11/13/14 13
  • 14. Diagnostic evaluation • History • Physical examination • Otoscopic examination • Culture • Audiometry ( testing of the hearing sense) & Tympanometry (evaluation of the mobility and patency of the eardrum) 11/13/14 14
  • 15.
  • 16. Management Medical Management- • Administration of antibiotic (Ampicillin or Amoxicillin). • Anti-inflammatory (analgesic & antipyretic). 11/13/14 16
  • 17. Management Surgical management- Myringotomy or tympanotomy (incision in the tympanic membrane) 11/13/14 17
  • 18. Nursing care • Apply hot water bag over the ear with the child lying on the affected side may reduce the discomfort (applied during the attack of pain). • Put ice bag over the affected ear may also be beneficial to reduce edema (between pain attacks). • For drained ear; the external canal may be frequently cleaned using sterile cotton swabs (dry or soaked in hydrogen peroxide).
  • 19. • Excoriation of the outer ear should be prevented by frequent cleansing & application of zinc oxide to the area of oxidate. • Give special attention to th tympanostomy tube i.e., avoid water entering the middle ear and introducing bacteria. • Educate family about care of child, & keep them aware with the complications of acute otitis media e.g.,hearing loss. • Provide emotional support to the child & his family.
  • 20. Complications of O.M • Hearing loss • Chronic suppurative O.M • Adhesive otitis • Facial palsy • Brain abscess. • Meningitis.