OTITIS MEDIA

 Definition:
Infection or inflammation of middle ear, the air filled
space behind the eardrum(tympanic membrane) that
contains the tiny vibrating bones of the ear.

 OM is the second most common clinical problem in

childhood after upper respiratory infection.
OTITIS MEDIA
Otitis Media - Classification
 Acute Otitis Media - rapid onset of
signs & symptoms, < 3 week course
 Sub acute Otitis Media - 3 wks to 3
months
 Chronic Otitis Media - 3 months or
longer
EPIDEMIOLOGY
 Peak incidence in the first two years of life (esp. 6-
12 months)
 Boys more affected then girls
 50% of children 1 yr of age will have at least 1
episode.
 1/3 of children will have 3 or more infections by
age 3.
 90% of children will have at least one infection by
age 6.
 Occurs more frequently in the winter months.
pathogens
 Streptococcus pneumoniae
 Haemophilus influenza
 Group A Streptococcus
 Staph. aureus
OTITIS MEDIA
 How does an ear infection occur?
The small space behind the eardrum in the
middle ear is normally filled with air.
It is connected to the back of the throat by a
tiny channel called the Eustachian tube.
The middle ear space sometimes becomes
filled with mucus, often during ‘cold’.
The mucus may then become infected by
bacteria or viruses.
OTITIS MEDIA
 How does an ear infection occur?
Children with glue ear who have mucus
behind their eardrum are more prone to ear
infections.
Sometimes an ear infection occurs ‘out of
the glue’ for no apparent reasons.
ACUTE OTITIS MEDIA
CAUSE-secondary to upper resp tract
infection

C/F-
-prolonged ear ache and heaviness
-pyrexia
-eardrum is reddened
-Drum gets retracted
-vommiting,tinnitus,babling sounds may be
present
TREATMENT

• Many cases resolve spontaneously but still

need observation
• The most common medical treatment options
include,
– Decongestion- the process of relieving congestion.
– Steroid nasal drops
– Mucolytics-is an agent which dissolves thick mucus
and is usually used to help relieve respiratory
difficulties.
– Antihistamines
– Antibiotics
 Surgical
-myringotomy/tympanotomy(puncture of
tympanic membrane for removal of fluid
or drainage of pus)
Complications
 Intratemporal
 hearing loss
 CSOM
 cholesteatoma
 mastoiditis
 labyrinthitis
 tympanosclerosis
 facial paralysis
Complications
 Intracranial
meningitis
extradural abscess
subdural empyema
focal encephalitis
brain abscess
CHRONIC OM
 Chronic infection of mucosa of middle
ear cleft
 It may be divided into 3 groups

1)Chronic suppurative om
2)Chronic non suppurative om/serous otitis
media
3)Chronic specific om
 Chronic suppurative om

• It is most common condition which simply means that

perforation(hole) is present in the tympanic membrane
• Chronic inflammation of middle ear and mastoid
cavity
Causes-
1)Upper resp. tract infection
2)Traumatic perforation
3)Head injury
4)unhygenic condition
5)Allergies and passive smoking
• c/f
-ottorhoea: discharge from ear
-deafness
-ear ache
-tinnitus
-giddiness
-bleeding
-swelling
Sign-perforation and tenderness over mastoid
DIAGNOSIS

-examination of ears
-audiogram
-bacteriological tests
-x-ray of mastoid
-CT scan/MRI
TREATMENT

-removal of septic foci

-aural toilet-cleaning of ear under
microscope
-ear drops
-mastoidectomy
-myringoplasty(repair of ear drum perforation)
-tympanoplasty(repair of ear drum and surgery
involving bones of inner ear)