Otitis Media: Classification, Incidence And Treatment
Otitis Media: It is an infection of the middle ear.
1- Acute otitis media (suppurative or purulent ).
2- Chronic otitis media ( also called secretory, serious and nonsuppurative ).
The inflammatory process of the middle ear with effusion collection as a result of auditory canal blockage. bacterial or viral agents cause purulent exudate to collect in the space of the middle ear behind the eardrum.
1- Suppurative otitis media:
a) Bacteriologic: Hemophilus influenza, beta-hemolytic streptococci or pneumococci.
b) Secondary: common cold, measles or scarlet fever.
2- Nonsuppurative otitis media:
b) Auditory canal dysfunction ( obstruction or abnormal patency ).
1- the auditory canal in children is shorter, wider and more horizontal, thus making the middle ear more accessible to the invasion of microorganism.
2- anatomic immaturity of tubal muscles and cartilage in children under two years of age.
3- certain craniofacial congenital defects e.g. cleft palate and down syndrome.
– Suppurative: in children under 5 years of age mostly below 2 years.
– Nonsuppurative: school-age children.
– Increase in winter and early spring.
1- History of common cold for several dates.
3- Older child: pain in the affected ear, headache, vomiting, and impaired hearing.
4- Infant: may rub ear, anorexia, turn head from side to side and/ or diarrhea.
5- Decreased hearing.
1- Chronic otitis media.
– Pneumatic otoscope: bulging, red eardrum, rupture drum may be obscured by secretions.
– Culture and sensitivity: for secretion of the ruptured eardrum or by myringotomy.
Identify the etiology.
Antibiotic according to culture and sensitivity.
Analgesic and antipyretic ( ear drops to relieve pain ).
Antihistaminic and decongestant.
Follow up hearing tests.
A) Myringotomy: opening in the tympanic membrane to allow drainage and relief pressure.
B ) Tympanostomy ventilating tube: the small plastic tube is inserted in the middle ear through the myringotomy incision.
C ) Tympanocentesis: aspiration of middle ear fluids.