Otitis Media

Anatomy of the ear
mechanism of hearing
1. Sound waves enter to EAC , causing vibration to the TM and attached ossicles in middles ear:
  1. Malleus attached to the center of TM & pulls the tensor tympani medially.
    1. Stapedius ms pull the stapes outward against the oval window.
      1. Set up waves in fluids of cochlea causing vibration of BM .
        up-and-down movement of waves to be changed into in-and-out motion of the tectorial membrane.
        Hair cells”steriocilia”> bend toward longer cells> excitation.
2. neurological pathway for hearing
Complications
1. Cholesteatoma
  1. Is epidermal cyst of the middle ear and/or Temporal bone with a squamous epithelial lining.
    1. progressive growth with erosion of surrounding bone due to pressure effects and osteoclast activation.
  2. types
    1. congenital
      1. no infection
    2. acquired
      1. with infection
    3. histologically
      1. keratin
      2. stratified squamous
      3. fibrous/granulation tissue
2. Aural polyps
  1. Benign proliferation of chronic inflammatory cells and granulation tissue that is usually lined with benign reactive epithelium.
    1. histologically
      1. Metaplastic squamous mucosa
3. cavernous thrombosis
4. lateral thrombosis
5. meningitis
6. abscess
7. empyema
causes
1. psuedomonas
2. moraxella
3. h influenzae
4. S. pneumoniae
one of the causes of discharge
1. other causes of discharge
  1. purulent
  2. mucoid
  3. blood stained
  4. serous
symptoms
1. pain
2. hearing loss
  1. other causes of hearing loss
    1. sensorineural
      1. ageing
      2. noise exposure
    2. conductive
      1. wax
      2. scar
3. vertigo and dizziness
  1. other causes
    1. hypoglycemia
    2. vestibular disease
    3. anemia
    4. alcohol
    5. moiton sickness
Physical Examination
1. otoscopy
  1. tympanic membrane red and bulging
2. auditory acuity
  1. Rinne
  2. Webber
3. Other Investigations
  1. tympanogram
  2. Ct
  3. MRI
  4. Treatment
    1. amoxicillin
      1. cefedmir
        clindamycin
    2. mastoidectomy

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Otitis Media

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Medienanhänge

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	Erstellt von Salma Moustafa vor fast 8 Jahre