Otitis Media(OM)

Outline
 Introduction
 Epidemiology
 Etiology
 pathogenesis
 Clinicalmanifestation
 Diagnosis
 Complication
 Treatment
 prevention
 Introductions
Otitis Media is defined as an inflammation of the
middle ear
Acute otitis Media(AOM) is an acute infection of
the middle ear.
It is the most common cause of hearing loss in
children.
An important characteristic of OM is its propensity
to become chronic and recur.
The definition of AOM includes: Recent, usually
abrupt, onset of signs and symptoms of middle-ear
inflammation(TM) and middle ear effusion (MEE).
  
Epidemiology

Over 80% of children will have

experienced at least one episode of otitis
media (OM) by the age of 3 yr.
The peak incidence and prevalence of
OM is during the 1st 2 yr of life.
Incidence greater in boys than in girls
Most of the studies have reported higher
rates in white children.
Etiology
Three pathogens predominate in AOM;
 Streptococcus pneumoniae(30-50%)
 Non type able Homophiles influenza(40-
50%)
 Moraxella catarrhalis(10%).
pathogenesis
• Infection mostly occurs in infants and
children because of the shorter and more
horizontal orientation of the Eustachian
tube which allows reflux from the
pharynx.
 Factors that affect the occurrence of OM

• Poverty, crowding, limited hygienic facilities,

• Sub optimal nutritional status,
• Limited access to medical care,
• Lack of breast feeding, exposure to tobacco
smoke, exposure to other Children
• Congenital Anomalies like un repaired palatal
clefts, other craniofacial anomalies, Down
syndrome and
• Lack of vaccination
 Clinical manifestation
•In young children, evidence of ear pain may be
manifested by irritability or a change in sleeping
or eating habits and occasionally, holding or
tugging at the ear .
Fever , Crying,
Rupture of the tympanic membrane with purulent
otorrhea is uncommon.
Symptoms associated with upper respiratory tract
infections also occur.
Occasionally there may be no symptoms
Hearing loss
Diagnosis
Is based on the history and otoscopic
examination which demonstrate red,
inflamed bulging or perforated ear drum.
Acute Otitis Media-TM
Complication of OM
Acute mastoiditis – infection of the
mastoid process.
Cholesteatoma – cystic lesion within the
middle ear.(a type of skin cyst that is located in the middle
ear and mastoid bone in the skull)
Meningitis.
Hearling loss.
Tympanic membrane perforation.
Brain abscess.
Treatment
Individual episodes of AOM should be
treated with antimicrobial drugs’
Amoxicillin for 10 days –first line
 Amoxicillin-clavulanate-second line for
10days.
prevention
General measures to prevent OM consist
of breast-feeding; avoiding, exposure to
individuals with respiratory infection,
avoiding environmental tobacco smoke,
and getting pneumococcal vaccination.