Otitis Media

Otitis media– Inflammation of the middle ear.

Causes and Incidence

Acute otitis media is usually the result of a bacterial or viral infection of the upper respiratory tract. When acute otitis goes unresolved, it leads to an effusion of the middle ear, called secretory otitis media. Otitis media is most commonly seen in infants and young children, typically in the winter and early spring.

Disease Process

Microorganisms migrate from the nasopharynx via the eustachian tube to the lining of the middle ear, where an inflammatory reaction is set up with edema and hyperemia, retraction of the tympanic membrane, and serous exudation. If a bacterial superinfection develops, the exudate becomes pus filled, causing the tympanic membrane to bulge.

Symptoms

The first manifestation is a severe, resistant earache marked by an erythematous tympanic membrane. Fever, nausea, vomiting, and diarrhea may also be present. Hearing loss and a fullness in the ears arecommon.

Potential Complications

Perforation of the eardrum, acute mastoiditis, petrositis, labyrinthitis, facial paralysis, epidural abscess, meningitis, brain abscess, sinus thrombosis, hydrocephalus, and subdural empyema are all possible complications.

Diagnostic Tests

The diagnosis is made by clinical evaluation. If pus is present, it may be cultured for the causativeorganism.

Treatments

Surgery
Myringotomy to drain pus or fluid from the middle ear if the tympanic membrane is bulging; tympanotomy ventilating tubes to create artificial eustachian tube in exudative otitis media.

Drugs
Antiinfective drugs to combat pathogen and infection; analgesics and antipyretics for pain and fever; antihistamines in allergic individuals to improve eustachian tube function; bronchodilators for adults.

General
Autoinflation techniques taught to children to prevent surgical placement of tubes; hearing evaluation; ear kept clean and dry after surgery; use of precautions when bathing to prevent getting water in the ear.