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DO NOT DO DRUGS !!! Hearing disorders in children/ Hala AlOmari1.

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Presentation on theme: "DO NOT DO DRUGS !!! Hearing disorders in children/ Hala AlOmari1."— Presentation transcript:

1 DO NOT DO DRUGS !!! Hearing disorders in children/ Hala AlOmari1

2 2

3 Lecture 8 24 February Hearing disorders in children/ Hala AlOmari

4 4 Acute otitis media  Chronic otitis media

5 Non-infectiveInfective Cause-Sudden Eustachian tube obstruction -Barotrauma -Locking of the Eustacian tube -Viral -Bacterial * often starts as viral but secondary bacterial infection may follow Pathology-Negative middle ear pressure -Acute retraction of the ear drum (very painful) -Effusion into the middle ear -Infection may follow -Proliferation of bacteria and white blood cells - ear drum bulges under pressure -Ear drum may burst (pus in the ear canal) Treatment-Swallowing -decongestants -Antibiotics - myringotomy Hearing disorders in children/ Hala AlOmari5

6  Symptoms - pain- increasing until the ear drum bursts - Pyrexia ( increased temperatures) - Unwell - Hearing loss  Consequences - Returns to normal - Persistent effusion - Permanent scarring of the ear drum - Perforation persists - Acute mastoiditis Hearing disorders in children/ Hala AlOmari6

7 - Very rare - Spread of the infection from the middle ear into the mastoid antrum and mastoid air- cells  Symptoms - Increasing pain - Increasing pyrexia - Swelling of the ear Hearing disorders in children/ Hala AlOmari7

8  Signs - Lateral displacement of the pinna - Maximum tenderness of the antrum (high) - Velvety feel to skin over the mastoid - Tragus not tender (characteristic of otitis externa)  Treatment - Intervenous antibiotics - Cortical mastoidectomy Hearing disorders in children/ Hala AlOmari8

9  Complications - Facial palsy - Labrynthitis - Intracranial pus _ Subdural abscess - extradural abscess - meningitis - brain abcsess Hearing disorders in children/ Hala AlOmari9

10  Forms - Chronic serous otitis media= otitis media with effusion= glue ear - Chronic suppurative otitis media - Long term complications of otitis media. Hearing disorders in children/ Hala AlOmari10

11  Ear infections are more common in children because their eustachian tubes are shorter, narrower, and more horizontal than in adults, making the movement of air and fluid difficult. Hearing disorders in children/ Hala AlOmari11

12  Eustachian tube malfunction - Anatomical - Nasal disease - Immune deficiency - Allergic rhinnitis - Adenoids - Cleft palate - Other mass post nasal Hearing disorders in children/ Hala AlOmari12

13  Middle ear hypoxia  Increase in mucous producing cells  Increase in mucous production Hearing disorders in children/ Hala AlOmari13

14  Hearing loss - variable ( dB)  Recurrent otalgia  Speech delay  Behavioural problems  Dizziness Hearing disorders in children/ Hala AlOmari14

15  Fluid behind the ear drum  Dull ear drum  Injection of ear drum  Retracted ear drum Hearing disorders in children/ Hala AlOmari15

16  Adenoids - snoring - mouth breathing  Cleft palate - depends on the type of repair Hearing disorders in children/ Hala AlOmari16

17  Pure tone audiogram (age appropriate)  Tympanometry  VRA  Eustachian tube function test Hearing disorders in children/ Hala AlOmari17

18 Hearing disorders in children/ Hala AlOmari18 Medical -Decongestants -Low dose antibiotics -otovent Surgical -Grommets -Adenoidectomy 3-4 months watchful waiting before the surgical intervention Depends also on when the child is seen (winter or summer)

19  Forms - Chronic serous otitis media= otitis media with effusion= glue ear - Chronic suppurative otitis media - Long term complications of otitis media. Hearing disorders in children/ Hala AlOmari19

20  Long term perforation  Two forms 1. Tubotympanic disease 2. Atticoantral disease Hearing disorders in children/ Hala AlOmari20

21  Tubotympanic disease - Perforation is central - Ear is safe - Not associated with cholesteatoma - Safe ear disease is characterized as a central perforation of the pars tensa with the inflammatory process affecting the mucosa of the middle ear cleft. Hearing disorders in children/ Hala AlOmari21

22  Symptoms - Hearing loss, variable dependent on the extent of the perforations - Discharge - Irritation  Investigation - Pure tone audiogram - Eustachian tube function test  Management - Hearing aid - Reconstruction Hearing disorders in children/ Hala AlOmari22

23  Atticoantral disease - Perforation- marginal in pars tensa at the attic - Affects the middle ear - Unsafe - Associated with cholesteatoma Hearing disorders in children/ Hala AlOmari23

24  Symptoms and signs - As for tubotympanic disease - Discharge is often offensive Both forms can have active discharge/ sometimes discharges/ inactive discharge Hearing disorders in children/ Hala AlOmari24

25  Cholesteatoma is a destructive and expanding growth consisting of keratinizing squamous epithelium in the middle ear and/or mastoid process. Although these are not strictly speaking tumours or cancers they can still cause significant problems because of their erosive and expansile properties resulting in the destruction of the ossicles as well as their possible spread through the base of the skull into the brain. They are also often infected and result in chronically draining ears. Hearing disorders in children/ Hala AlOmari25

26  Forms - Chronic serous otitis media= otitis media with effusion= glue ear - Chronic suppurative otitis media - Long term complications of otitis media. Hearing disorders in children/ Hala AlOmari26

27  Tympanoscelerosis  Retraction pockets  Atelectasis (drum is floppy)  Adhesive otitis media - Effects - CHL - Altered compliance Hearing disorders in children/ Hala AlOmari27


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