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Acute otitis media
- 2. Pathology
• Inflammation of the middle ear cleft mucosa and
associated ET tube
• Acute < 3 weeks
• Originate as an infection – bacterial, viral
• Bacteria Streptococcus pneumoniae,
Haemophilus influenzae, Morexella catarrhalis ;
infants ~20% Gm –ve enterobacteria
• Viruses isolated in 4% RSV, Influenza
• Causes a blocked ET middle ear fluid
- 4. Symptoms
• Ear ache
• Discharge
• Hearing Loss
• Fever
• Irritability
- 5. Signs
• General Fever
Toxic
• Local Red TM
Perforation
Free Field tests HL
WT
RT (-) ve
VII / Nystagmus (complications)
Mastoiditis
- 7. Treatment
• Antibiotics - Amoxycillin, Co–Amoxyclav
• Nasal Decongestants
• Steam
• Anti-pyretic
• Analgesics
• Anti-histamines
- 8. Complications
Intratemporal
• CHL,SNHL
• Perforation
• Retraction pocket
• Cholestetoma
• Tympanosclerosis
• Ossicular chain fixation or disconiniuity
• Mastoiditis
• Petrositis / Gradenigo
• Labyrinthitis
• PLF
• VII
• Cholesterol granuloma
- 9. Complications
Intracranial
• Extra-dural Abscess
• Meningitis
• Sub-dural empyema
• Focal otitic encephalitis
• Lateral Sinus thrombosis
• Otitic hydrocephalus
• Intracerebral Abscess