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Published byKaelyn Heys
Modified about 1 year ago
Otology Dave Pothier St Mary’s 2003
Anatomy Not a big place Lots of bits NB concepts only
Hearing Conductive Sensorineural
The ‘otitises’ Acute Suppurate Otitis Media Chronic Suppurative Otitis Media Otitis Media with Effusion / Secretory Otitis Media Adhesive Otitis Media +/- Cholesteatoma
ASOM Common ear infection Pus in middle ear Organisms from ET Pain, fever, deafness Often perforated TM
Organisms Strep pneumoniae Haemophilus Influenzae
Complications: Intracranial Meningitis Intracranial abscess Sigmoid/lateral sinus thrombosis Extracranial Mastoiditis and sequelae Facial nerve palsy Labyrithitis Sensorineural hearing loss
Sequelae Glue ear TM perforation Adhesions Tympanosclerosis Ossicular erosion
Rx Conservative / medical / surgical Observe Analgesia Antibiotics (Amoxil) +/- myringotomy
Mastoiditis Spread of infection to mastoid air cells form middle ear cleft – serious disease; easy spread to important structures From ASOM / cholesteatoma
Signs Unwell Deaf ASOM Ear protruding Not always reliable
Rx Resus Admit IV abx Early surgery if no response
Glue ear / SOM / OME NOT INFECTIVE
Glue ear / SOM / OME Caused by ETD (Eustacian tube dysfunction) Negative MEP Effusion of fluid in Middle ear No pain, no fever, not unwell Deafness, poor development of speech, behaviour
Rx Cons / Medical / Surgical Watch & wait Hearing Aid Ventilation tube
Conservative Hearing loss in context Speech / developmental issues Follow-up Seasonal Self limiting
Hearing aid Effective Compliance
Ventilation tubes (grommets)
NB NO ANTIBIOTICS
Cholesteatoma What is it? Keritinising squamous epithelium in middle ear cleft
How? Congenital (rare) Aquired - primary (retraction) - secondary (implantation) Cholesteatoma
‘Conveyor belt’ Skin migrates from umbo outwards across TM and out along canal
Pars flaccida ( 2 layers ) Pars tensa ( 3 layers)
Eustacian tube dysfunction Negative MEP Retraction of pars flaccida RP fills with debris Infection Erosion and spread
Complications Same as ASOM + mastoiditis But more insidious Slow erosion more common
Rx Conservative / medical / surgical Conservative - microsuction, review Medical – antibiotic drops Surgical – cortical mastoidectomy
CSOM Perforation of TM Follows a slow to heal ASOM May be active or inactive Safe / Unsafe perforation Mucosal or cholesteatoma Similar principles to cholesteatoma safe unsafe
Otitis Externa Inflammation of EAM +/- infection debris TM
Pathogens Pseudomonas Staph Aureus Mixed growth
Causes Trauma Cotton buds Fingers H20 in ear Eczema Narrow canals
Rx Microsuction / aural toilet Topical Topical antibiotic drops Water precautions Leave oral / IV until specialist review
Malignant OE Often in immunocompromised + Diabetics Not mitotic! Aggressive OE – cranial nerve palsies Base of skull disease Emergency referral for surgery and Abx
Approach to Ear Problems By Stacey Singer-Leshinsky R-PAC.
Otitis Media Lawrence Pike. Definition Inflammation of the middle ear nearly always preceded by an URTI. Inflammation of the middle ear nearly always.
Audiology Resource Notebook This presentation is intended as a resource for professionals in Deaf Education, Audiology, and Speech Pathology. It includes.
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Clinical Examination of the Ear, Nose and Throat Dave Pothier St Mary’s 2003.
1 OTITIS MEDIA WITH EFFUSION ----(OME). 2 overview Otitis media with effusion (OME) is characterized by accumulation of fluid in the middle ear, conductive.
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Infections in the Immunocompromised Host Ranjbar M.
Keeping Kids Healthy Dr. Emily Maiella Naturopathic Physician 432 Greenfield Rd Montague MA
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Minor Illness Amy Tatham & Freeda Bhatti. Definition Any condition which is self limiting and does not prevent the patient from carrying out their normal.
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