A Family Doctor's Tale - OTITIS MEDIA

DOC I HAVE OTITIS MEDIA

Otitis Media is a fairly common infection of the middle ear.

The danger is infection from the nose spreading through the eustachian tube to the middle ear.

Infection of the middle ear can result in the bursting of the ear drum, with pus coming out of the external ear.

In addition infection can spread to the bones of the skull (the mastoid) and the brain .

Proper treatment with antibiotics can normally clear the infection.


Otitis media is acute or chronic inflammation of the middle ear.

Otitis media occurs in the area between the ear drum (the end of the outer ear) and the inner ear, including a duct known as the Eustachian tube.

Otitis media occurs in:
1.childhood, usually related to viral upper respiratory tract infection

2.family history of middle ear disease.

The Causes of Otitis media are:


Bacterial Infections:

1.Streptococcus pneumoniae

2.Haemophilus influenzae

3.staphylococcus aureus

4.Moraxella catarrhalis, a gram-negative diplococcus.

5.Mycobacterium tuberculosis.

6.E.coli

Viral infections:

1.common cold.

2.measles

The Types of Otitis Media are:

1. Acute otitis media

Acute otitis media is an acute infection of the middle ear which usually occurs as a result of viral upper respiratory tract infection that can occur at least twice a year

2.Chronic otitis media

Chronic otitis media occurs following acute otitis media with chronic infection of the middle ear and ear perforation.

3.Otitis media with effusion:

Otitis media with effusion occurs when fluid occurs in the middle ear due to blockage of the eustachian  tube.

The complications of Otitis media are:

1.mastoiditis

2.labrynthitis

3.facial nerve palsy

4.meningitis,

5.brain abscess,

6.febrile seizures.

7.death if a severe infection goes untreated long enough

Symptoms and signs of Otitis media:

1. cold: stuffy nose

2. earache - The pain lasts a day or two.

3. high fever - may cause seizures if very high

4. discharging pus from the ruptured eardrum

Usually the ruptured drum will usually heal spontaneously

5.Eustachian tube becomes blocked resulting in hearing loss

Signs:

1.Ear drum (tympanic membrane) inflamed and bulging with loss of normal outline

2.Decreased or displaced light reflex of ear drum


3.perforation of ear drum

4.mucopurulent discharge from ear after perforation

Diagnosis of Otitis media is made by:

1.Inflamed ear drum with loss of normal outline, decreased light reflex, bulging and perforation and purulent discharge.

2.Culture and sensitivity of pus swab

3.Nasal and pharyngeal swabs my also be done

4.X-rays or MRI of the mastoid air cells

5.Audiogram for hearing loss

Treatment of Otitis media:

Acute otitis media

1. Antibiotics may be commenced if fever is high or the culture showed bacterial infections.

2.Fever and pain may be treated with paracetamol

3.Antihistamines may be given for rhinitis or runny nose.

4.Decogestants may be necessary for blockage of eustachian tube

5.Bed rest and Fluids

6.Myringoplasty -

Puncture of bulging ear drum if painful and aspiration of

pus or fluid in the middle ear.

7.Tympanoplasty for eardrum whose perforation does not heal.

8.Mastoidectomy to remove cholesteatoma(growing of skin into middle ear cavity) in chronic otitis media with mastoiditis.

The prognosis of Otitis media with appropriate treatment is generally good.

Ear drum perforation usually heal spontaneously in most cases.

Preventive measures for Otitis media  are:

Avoid swimming and diving.

Proper ear hygiene.