ASOM Flashcards
Involves
Eustachian tube
Middle ear
Attic
Aditus
Antrum
Mastoid air cells
Routes of infection
Lumen of tube.
Along subepithelial peritubal lymphatics.
Higher incodence in children and breast fed babies.
Swimming and diving
External ear
Traumatic perforation in tympanic membrane
Blood borne
Predisposing factors
Reccurent
Common cold
URTI
Exanthematous fever (measles, diphtheria, whooping cough)
Tonsil / adenoid infection
Chronic rhinitis and sinusitis
Nasal allergy
Tumours of nasopharynx
Nasopharynx epistaxis
Cleft palate
Bacterias
S pneumoniae
H influenza
Moraxella catarrhalis
S pyogenes
S aureus
P aeruginosa
Pathological stages
Stage of tubal occlusion
Stage of exudation or presuppuration
Stage of suppuration
Stage of resolution
Stage of complications
Stage of tubal occlusion
Odema + Hyperaemia (nasopharyngeal end of tube)(absorption of air)(nehgative intratympanic pressure)
Retraction of tympanic membrane
Hearing loss
Earache
Prominence of lateral process of malleus
Loss of light reflex
Conductive deafness
Stage of exudation/ presuppuration
Hyperaemia in lining
Inflammatory exudate in middle ear
Congested tympanic membrane
Earache (sleep disturbance)(throbbing)
Hearing loss (conductive)
Tinnitus
High fever + restlessness (child)
Congested pars tensa
Blood vessels (Cart wheel appearance)
Pars flaccida (uniformly red)
Stage of suppuration
Pus formation in middle ear and mastoid air cells
Bulged tympanic membrane
Earache (excruciating)
Hearing loss increases
High fever
Vomiting convulsions
Tympanic membrane (red + bulging)(nipple like protrusion)
Handle of malleus (engulfed + swollen)
Yellow spot on membrane (rupture is iminent)
Tender mastoid antrum
X-ray (clouding of air cells)
Myringotomy indicated
Stage of resolution
Release of pus (tympanic memberane rupture)
Inflammatory process resolve
Earache relieved
Fever down
Pus evacuation
External ear canal has blood-tinged discharge (later mucopurulent)
Perforation in anteroinferior of pars tensa.
Hyperaemia of tympanic
Stage of complications
Disease spreads
Acute mastoiditis
Subperiosteal abscess
Facial paralysis
Labyrinthitis
Petrositis
Extradural abscess
Meningitis
Brain abscess
Lateral sinus thrombophlebitis
Treatment
Antibiotics
Ampicillin
Amoxicillin
Penicillin/ cotromoxazole/ erythromycin
Amoxiclav
Cefixime
Cefuroxima axetil
Inadequate therapy leads otitis media with effusion + residual hearing loss
