Definition:- It is an inflammation of middle ear or infection of middle ear caused by entrance of pathogenic organisms.
An infection of the air-filled space behind the eardrum ( the middle ear).
An ear infection is usually caused by bacteria or virus.
Causes:- otitis media is inflammation or infection located in the middle ear. Otitis media can occur as a result of a cold, sore throat, or respiratory infection.
Types:-
It is mainly of three types.
- Acute O.M. (Suppurative otitis media).
- Serous O.M.
- Chronic O.M.
Acute otitis media:-
It is an acute infection of middle ear usually lasting less than 6 weeks.
Serous otitis media:-
It means accumulation of serous fluid in middle ear without evidence of active infection, but fluids results from a negative pressure in the middle ear caused by tube Eustachian obstruction.
Chronic otitis media:-
It is the results of repeated episode of acute O.M. causing irreversible tissue pathology and persistent perforation of tympanic membrane. It also leads to mastoid bone infection.
Clinical manifestation:- (Acute otitis media).
- Pain.
- Hearing loss.
- Purulent drainage (Otorrhea).
- Fever may be rise to 104°f 105°f.
- Irritability.
- Headache.
- Anorexia.
- Nausea and vomiting.
Chronic otitis media:-
- Otalgia (ear pain).
- Redness and swelling.
- Perforation of tympanic membrane.
- Tinnitus (Ringing sound hears in ears).
- Dizziness.
- Building of tympanic membrane.
- Obstruction of Eustachian tube.
Complications:-
- Meningitis.
- Brain abscesses.
- Epidural abscesses.
- Mastoiditis.
- Permanent sensorineural.
- Hearing loss.
- Death.
Medical management:-
Broad spectrum antibiotics therapy. — Amoxycillin (Amoxyclave). — Penicillin. — Macrolides (Azithromycin). — Trimpethoprim — sulfamethoxazole ( bacterium). May be used in penicillin allergy. — Antihistamines e. g. Phinamine maleate, chlorphenamine. NSAIDs drugs, (for inflammation and pain). aspirin. Antiseptic ear wash with antibiotic therapy in case of chronic otitis media.
Surgical Management:-
Myringotomy:-
Incision of the eardrum to create an artificial opening, either to allow infected fluid to drain from the middle ear in acute otitis media.
Tympanotomy:-
A surgical operation to expose the middle ear and allow access to the ossicles. It is usually performed by using around the eardrum and turning it forwards.
Tympanoplasty:-
Surgical repair of tympanic membrane ( eardrum) or surgical repair of a perforated eardrum by grafting.
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