1. OTITIS

2. Presented by :
Alisius Heru Setiawan Nainggolan ( ) Ninik Kurnia ( ) Ayu Iska ( ) Rona Henrry ( ) Febri Evalina ( ) Prasetya Tunggal Dewa ( ) Yanuar Hari Putra ( ) Pinky Melinda ( )

3. definition
Otitis means inflammation of the ear, and media means middle, which is characterized by pain, fever, loss of hearing, tinnitus and vertigo. So otitis media means inflammation of the middle ear either part or all of the middle ear mucosa.

4. Classification of otitis
Otitis externa is infection of the skin covering the outer ear canal that leads in to the ear drum, usually bacterial, of the auditory canal and sometimes the external ear. Otitis media is due to allergy or viral or bacterial infection of the middle ear. Otitis interna is an inflammation of the inner ear and is usually considered synonymous with labyrinthitis.

5. FACTS ABOUT OTITIS MEDIA
• Societal Costs
– $5.3 billion estimated national direct costs annually.
– $8 billion estimated when indirect expenses are taken into account.
• Incidence of OM
– 60% will experience OM in 1st year.
– 17% will have recurrence that year.
– 250% increase in incidence of OM from
• Risk Factors for developing OM
– Large daycare, exposure to cigarette smoke, pacifier use beyond
10 months, formula fed.
• Risks of complications of OM
– Very rare 1 in 10,000 experience infectious complication such as
mastoiditis or meningitis leading to serious illness or death.

6. CAUSES
Ear infections happen when the Eustachian tubes are blocked. Blockages can be caused by: 1. A respiratory infection, such as cold or flu 2. Allergies 3. Exposure to cigarette smoke 4. Infected or overgrown adenoids (tonsils) For infants, being fed lying down (drinking a bottle while lying on the back). Ear infections happen most often in the winter. They are not contagious, but a cold may spread among a group of children and cause some of them to get ear infections.

7. SYMPTOM
There are two main types of ear infections: acute otitis media (AOM), and otitis media with effusion (OME), where fluid remains trapped in the ear even after the infection is gone. Acute otitis media causes pain, fever, and difficulty in hearing. If a child is too young to talk, signs of an ear infection can include crying, irritability, trouble sleeping, and pulling on the ears. Other symptoms that may be associated with an ear infection include sore throat (pharyngitis), neck pain, nasal congestion and discharge (rhinitis), headache, and ringing (tinnitus), buzzing, or other noise in the ear.

8. Theory of otitis
Otitis media is often begin by respiratory infections such as strep throat or a common cold which spread to the middle ear through the Eustachian canal. When the bacteria through the Eustachian canal, they can cause infections resulting in swelling around the canal. White blood cells kill the bacteria at the expense of themselves. As the result, forming pus in the middle ear. In addition, tissue swelling around the Eustachian canal causes mucus produced by cells accumulate in the behind the eardrum.

9. Prevention of Otitis Avoid swimming in contaminated water.
Swimmer's ear can be prevented from otitis with liquid containing a mixture of alcohol and vinegar, before and after swimming.
Avoid soaking too long in warm water in humid climate.
Avoid cleaning the ear too deep, it can cause the dirt to accumulate in the ear canal (Abdullah).

10. Prevention of Otitis FOR Children
Give exclusively breastfed for the first 6 months. Antibodies in breast milk helps protect children from Otitis Externa.
Avoid giving drink with sleeping position.
Keep children away from cigarette smoke and air pollution.
Reduce exposure to other children affected by the common cold.
Teach the children to keep their hand hygiene.
Children who are too young should not be included school or daycare. When forced, the group with fewer children is better. At the age of four, endurance of children begin a bit stronger.

11. RISK factors Risk factors for otitis media include:
Age children between months are most likely to get ear infections.
Attending daycare.
Recent illness, such as a cold or sinus infection.
History of allergies, like hay fever, also called allergic rhinitis, or sinusitis.
Exposure to secondhand smoke.
Having family members who are prone to ear infections.
Using a pacifier.

12. Medications
Antibiotics.
Ear drops.
Ibuprofen.
Acetaminophen

13. Prognosis and Complications
Usually, an ear infection is a simple condition without complications. Most children will have minor, temporary hearing loss during and right after an ear infection. Permanent hearing loss is very rare, but the risk increases if the child has a lot of ear infections. Other potential complications include: • Ruptured or perforated eardrum, which usually heals on its own • Chronic, recurrent ear infections • Enlarged adenoids or tonsils • Mastoiditis, an infection of the bones around the skull • Speech or language delay in a child who suffers lasting hearing loss from multiple, recurrent ear infections; very rare

14. REFERENCE
Elise G. Hewitt, January 15, 2008, Chiropractic Care for Otitis Media: Clinical Rationale, State of Research and Treatment Protocols, October 19, 2014.
Emirza Nur Wicaksono, March 27, 2013, Otitis Media, www. emirzanurwicaksono.blog.unissula.ac.id/2013/03/27/otitis-media/, October 21, 2014.

15. FOR YOUR ATTENTION