chronic otitis meedia Flashcards

1
Q

what are the two main types of chronic otitis media?

A

mucosal type and squamous type

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2
Q

what are the features of the mucosal type of chronic otitis media?

A

recurrent or persistent ear infection in the presence of a tympanic membrane perforation , previously known as safe type

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3
Q

what are the features of squamous type of chronic otitis media ?

A

gross retraction of thee tympanic membrane with formation of a keratin collection ( el heeya el cholesteatoma), previously known as the unsafe type

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4
Q

what are the types of mucosal chronic otitis media ?

A

active mucosal - wet perforation with inflamed middle ear mucosa and discharge
inactive mucosal - dry perforation

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5
Q

what are the types of squamous chronic otitis ?

A

inactive squamous - retraction pocket , which has the potential to become active
active squamous - cholesteatoma

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6
Q

what are the causes of mucosal chronic otitis media ?

A

chronic inflammation due to persistent tympanic membrane perforation secondary to acute otitis media

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7
Q

what is the most common age group associated with Mucosal COM ?

A

children and adults

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8
Q

what are the most common pathogens associated with mucosal chronic otitis media ?

A

pseudomonas aeruginosa
Staphylococcus Aureus

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9
Q

what are the symptoms of mucosal chronic otitis media ?

A

hearing loss
otorrhea: persistent or intermittent, profuse, mucopurulent or mucoid

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10
Q

what are the signs of the mucosal inactive type ?

A

dry perforation with thin pale pink middle ear mucosa

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11
Q

what are the signs of thee mucosal active type ?

A

wet perforation with middle ear inflammation, middle ear mucosa is oedematous and congested

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12
Q

what are the complications of mucosal chronic otitis meedia ?

A

mastoiditis
intracranial complications
facial nerve palsy

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13
Q

what are the investigations done in cases of mucosal chronic otitis media ?

A

pure tone audiometry
swab from the external auditory canal
CT scan of temporal bone if complications are suspected

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14
Q

what is the treatment for mucosal chronic otitis media ?

A

medical - aural toilet with repeated microsuction
ab and steroid combination ear drops if discharge is present
surgical - myringoplasty , surgical repair of the tympanic membrane using cartilage or fascia

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15
Q

what is the pathology associated with squamous chronic otitis media ?

A

the squamous cells hyper proliferate and secrete osteolytic enzymes and can lead to secondary bacterial infections

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16
Q

what are the types of cholesteatoma ?

A

acquired and congenital

17
Q

what are the causes of acquired cholesteatoma ?

A

retraction pocket ; retraction of thee tympanic membrane happens due to eustachian tube dysfunction
or
due to chronic perforation

18
Q

how is a congenital cholesteatoma diagnosed ?

A

diagnosed in children who have an intact tympanic membrane and no history of ear surgery

19
Q

what are the symptoms of squamous chronic otitis media ?

A

persistent and sometimes recurrent scanty offensive discharge
hearing loss

20
Q

what are the signs of squamous chronic otitis media ?

A

retraction pocket
adjacent bony erosion
keratin debris within the pocket
purulent discharge with foul odour
granulations
middle ear polyp
TM perforation - if acquired

21
Q

what does congenital squamous chronic otitis media look like ?

A

Tympanic membrane is intact with whitish pearly mass behind in congenital cholesteatoma

22
Q

what are the investigations for squamous chronic otitis media ?

A

pure tone audiometry
swab for the external auditory canal
CT scan of temporal bone

23
Q

what is the treatment for sq COM ?

A

surgical only
mastoidectomy

24
Q

recurrent ear discharge with hearing loss is associated with ?

A

chronic otitis media