Ear Treatment

ACUTE OTITIS MEDIA

It is an Acute infection affecting the mucosal lining of the middle ear cleft and the mastoid air-cell system. It often follows an upper respiratory tract infection.

Incidence

ASOM is usually seen in infants and children of low socioeconomic status.

Causative Organisms:
  • Beta hemolytic streptococci and streptococcus pneumonia.
  • Haemophilus influenzae.
  • Staphylococcus aureus.
  • Moraxella Catarrhalis.
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Pathological stages :
  • Stage of Eustachian tube obstruction: It occurs due to edema and congestion of the mucosal lining of the Eustachian tube leading to the negative pressure inside the middle ear leading to mild retraction of the tympanic membrane.
  • Stage of Exudation: Middle ear mucosa becomes edematous and congested, resulting in serous exudation inside the middle ear cavity.
  • Stage of Suppuration: There is an accumulation of purulent and mucopurulent secretions inside the middle ear, this causes bulging of the tympanic membrane. The tympanic membrane ultimately ruptures leading to perforation of the drum.
  • Stage of Resolution: The condition is self-limiting in most of cases depending on the virulence of the organism, the immunity of the patient, and the effect of medicines. The tympanic membrane starts healing and the hearing gradually improves.
  • Stage of Complication: When the infection spreads beyond the middle ear cleft, it may cause mastoiditis, subperiosteal abscess, facial paralysis, labyrinthitis, petrositis, extradural abscess, subdural abscess, meningitis, or brain abscess.
Clinical Picture
  • 1) Stage of Eustachian tube obstruction:
    Symptoms: Mild deafness (autophony).
    Signs: mild drum retraction and mild conductive hearing loss.
  • 2) Stage of Catarrhal otitis media:
    Symptoms: Pain, deafness, tinnitus, and mild fever.
    Signs: Congested tympanic membrane (Cartwheel appearance) with mild to moderate conductive hearing loss.
  • 3) Stage of suppuration:
         
    • a) Before perforation:
      Symptoms: Severe ear pain, fever, deafness, and tinnitus.
      Signs: Bulging tympanic membrane which is severely congested with a pale center. Moderate conductive hearing loss.
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    • b) Post Perforation:
      Symptoms: Pain disappears and fever drops down, mucopurulent and purulent discharge comes out. Mild deafness and tinnitus are present.
      Signs:Discharge in the external ear canal, mucoid or mucopurulent, and tympanic membrane perforation. Mild conductive deafness.
  • 4) Stage of Resolution:
    Resolution gradually occurs with the subsidence of symptoms and signs. The resolution may be complete or incomplete.
Treatment:
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