3 - ENT - Otology - Conductive deafness - Otitis Media Flashcards
3 main types of OM
OM w effusion (glue ear)
Acute suppurative otitis media
Chronic suppurative otitis media
Otitis media with effusion (glue ear) - cause? leads to? commonly follows?
NON-infective
sterile collection of fluid in middle ear due to pharyngotympanic tube dysfunction
commonly follows URTI, acute suppurative OM
OM w effusion - ass w? main cause of what? usually resolves within?
ass w large adenoids
main cause of hearing loss in children - may cause learning problems
usually within a few weeks
OM w effusion - mgmt
-initially? what are of no benefit? then what?
-reassurance and follow up within 3 months - 50% improve
AB’s, antihistamines and decongestants of no benefit
if hearing loss persists - insert grommets
What do grommets do? when do they come out? counselling?
ventilate middle ear
usually extrude spontaneously after 3-12 months - may need reinsertion
swimming OK but avoid diving- keep dry as poss
Acute suppurative otitis media - what is it? 4 presenting points?
bact infection of middle ear
presents with - pain, fever, anorexia, vomiting
Acute suppurative OM - what can form ? leading to? healing time?
pus formation leading to TM bulging leading to rupture with pus leaking into external canal
Acute suppurative OM - mgmt
analgesia, amoxicilin/co-amoxiclav (7days)
myringotomy if failure to resolve or there are complications
Acute suppurative OM - complications?
mastoiditis, labyrinthitis, facial palsy, meningitis, intracranial abscess
Chronic suppurative OM - disease of? what happens?
diseased middle ear mucosa - repeated infection, hyperplasia/hypertrophy, and microabscess formation
Chronic suppurative OM - Sx and signs
little pain, conductive hearing loss, odourless chronic discharge if TM perforation
chronic suppurative OM - may lead to? mgmt?
may lead to intracranial sepsis, cholesteatoma
mgmt- AB’s, myringoplasty
