What is otitis media-its causes

What is otitis media 

                    

  INTRODUCTION OF OTITIS MEDIA :-

The term Otitis means, inflammation of the ear and media means, middle.

Otitis media is infection or inflammation of the middle ear.

It is can occur as a result of a cold, sore throat or respiratory infections. 

 otitis media occurs in the area between eardrum and the inner ear, through the duct known as ‘’Eustachian tube’’.

It is the most common disease of middle ear in children and does occurs in children and does occurs in adults.

Other names of Otitis media:   

              1.titis media with effusion

              2.Serous otitis media

              3.secretory otitis media 

 

> CLASSIFICATION OF OTITIS MEDIA

There are Two types 

-Acute otitis media        -chronic otitis media           

1. Acute otitis media :-It is an acute infection and inflammation of the middle ear mucosa.

•  It is caused by mostly bacterial organisms, which enters into the middle ear through eustachian tube.

   

•  It is usually of rapid onset and short duration.

 Causes of acute otitis media:-

1.        Bacterial causes:        

 Streptococcus pnumoniae 

 Haemophilus   influenza 

 Morexella 

2 .  Viral causes: 

Rhino virus  

Respiratory syncytial virus (RSV)  

Risk factors of acute otitis media: -     

Family history

Low birth weight baby

Altered immunity

 GERD

Tonsilites

Frequent respiratory tract infections(RTI)

Crowded living  conditions

Diphtheria

Pertusis

Low socio economic status

  Clinical manifeststions of acute otitis media:-            

▪ Sudden and severe otalgia.

▪ Hearing loss

▪ Tinnitus

▪ Sense of fullness

▪ Irratibilioty

▪ Mastoid tentenderness

▪ Fever

▪ Headache

▪ Restlessness

▪ Balance problems

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Pathophysiology of acute otitis media:-        

  

Due to etiological factors

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Infection and inflammation of nasopharynx.

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Obstruction of ET Tube

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Middle ear absorbed air does not pass due to obstruction.

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Negative pressure occurs in middle ear.

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It pulls interstitial fluid into the middle ear.

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  Effusion occurs.

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   Over growth of micro     organisms in middle ear.

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     Acute otitis media

Diagnostic evaluation of otitis media:-

▪ History Collection and ▪ physical examination 

▪ Audiometry test

▪ Lab studies 

▪ C.T. scan

Medical management of acute otitis media :-

Antibiotics:   Amoxicillin  with clavulaunic  acid.

Analgesics: 

            -Ibuprofen

          -Acetaminophen

         Surgical. Management of acute otitis media :- 

      Tympanocentasis:-  

           Withdrawal of fluid from the middle ear by inserting a needle catheter through the tympanic membran.

      Myringiotomy:-

      A permanent opening is made into the tympanic membrane for the excessive fluid discharge, if it accumulate in the middle ear.

     2.CHRONIC OTITIS MEDIA 

        •Inflammation of middle ear with tissue damage usually, caused by repeated episodes of acute otitis media .
          
   •Chronic otitis media may develop after a prolonged period of time with effusion and negative pressure behind the tympanic membrane.

  Also read this pharmacodynamic    

     C  Causes of chronic otitis media:-

• Repeated acute otitis media. 
• Other  cause same as acute otitis 

       Pathophysiology of chronic otitis media:- 

                                   DTEF 

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                      Acute otitis media

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Damage to surrounding tissues of middle ear

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                     Chronic otitis media.

👉👉Cycle of infection:-

inflammation,ulceration,granulation of tissues, May

continuous destroy tympanic membrane and bony ossicles.

Clinical manifestations of chronic otitis media:-

Hearing loss

Headache

Fever

Confusion

Menstrual tenderness

Tinnitus

Diagnostic evaluation of chronic otitis media:- 

-History collection and physical examination

-CT scan and MRI

-Audiometry test.

Medical management of chronic otitis media:- 

Antibiotics,Analgesics,antipyretics.

Surgical management of chronic otitis media:-

1. Tympanoplasty- A graft is placed to restore damaged tympanic membrane.

2. Ossiculoplasty- Surgical repairing of ear ossicles.

• Nursing management of otitis media:-

   Nursing diagnosis:-

    1. Pain Related to the inflammation and pressure on the tympanic membrane.

    2. Impaired verbal communication related to hearing deficit

     3. Risk of infection related to obstruction in ET Tube.

  4. Fear or anxiety related to surgical procedure.

•   Nursing interventions:-

   •Assess and document the   location,intensity,and    frequency of pain.

    •Observe the ear can for inflammation and swelling and tympanic membrane for redness.

     •Give analgesics such as pcm or use of anal gesic ear drops.

       •Apply heating pad or warm hot water bottle.

  •Assess changes in hearing acuity,assess audiogram or tympanogram.

     •Avoid shouting, use simple language and short sentence, speak slowly.

  •Prepare patient for ear surgery such as tympanoplasty.

 •Assess symptoms include otalgia,otorrhea,hearing loss or vertigo.

   •Perform otoscopic examination,check for drainage in ear canal.

   •Administer antibiotics,antipyretics and anti inflammatory drugs as prescribed.

  •Encourage patient for adequate nutrition,rest and exercise and for washing hands frequently.

     •Assess and observe patient for anxiety.

    •Explain procedure in details to patient and his family.

     •Assess vitals timely.

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