Otitis Media

Marie Jeanne Devilles R.N

Ma. Russele Samong R.N

Otitis Media

Inflammation in the middle ear area is known as

otitis media.
A child with otitis media usually exhibits a discolored
membrane ( bright red, yellow, or dull gray).
Streptococcus pneumoniae is found in 40% of
patients with acute otitis media.
Acute otitis media means that fluid (usually pus) is
in the middle ear, causing pain, redness of the
eardrum, and possible fever.
In some cases, otitis media can be more chronic
(with fluid in the middle ear for 3 months or longer).

Other Types of Otitis Media

Chronic suppurative otitis media is a
persistent ear infection that results in
tearing or perforation of the eardrum.
In Otitis Media with effusion, fluid in
the middle ear can be temporary and not
necessarily infected.
Adhesive
otitis media occurs when a
thin retracted ear drum becomes sucked
into the middle ear space and stuck.

Causes of Otitis Media

Kids are prone to developing ear infections in the first
2 to 4 years of life for several reasons:

Their eustachian tubes are shorter and more

horizontal than those of adults, which lets bacteria
and viruses find their way into the middle ear
more easily. The tubes are also narrower and less
stiff, so more at risk for blockage.
The adenoids, which are gland-like structures
located in the back of the upper throat near the
eustachian tubes, are large in children and can
interfere with the opening of the eustachian tubes.

Etiology of Otitis Media

Males

Individuals with a family history of ear infections

Babies who are bottle-fed (breastfed babies get

fewer ear infections)

Children in day care centers

People living in households with tobacco smokers

People with abnormalities of the palate, such as a

cleft palate
People with poor immune systems or chronic
respiratory diseases, such as cystic fibrosis and
asthma

Signs and Symptoms

AOM implies rapid onset of disease associated with
one or more of the following symptoms:

Otalgia (ear pain)

Otorrhea (drainage of liquid from the ear)

Headache

Fever

Irritability

Loss of appetite

Vomiting and Diarrhea

Signs and Symptoms

OME often follows an episode of AOM.
Symptoms that may be indicative of OME
include the following:

Hearing loss

Tinnitus

Vertigo

Otalgia (ear pain)

Diagnosis

Doctor should be able to make a diagnosis by taking

a medical history and doing a physical exam.
A test called tympanometry is an accurate tool for
diagnosing OME. The results of this test can help tell
the amount and thickness of the fluid.
An acoustic otoscope or reflectometer is a
portable device that accurately detects fluid in the
middle ear.
An audiometer or other type of formal hearing test
may help the health care provider decide on
treatment.

Treatment

Most cases of AOM improve spontaneously. Cases that require

treatment may be managed with antibiotics and analgesics or
with observation alone. (Guidelines from American Academy of
Pediatrics)
In February 2013, the American Academy of Pediatrics (AAP) and
the American Academy of Family Physicians released updated
guidelines for the diagnosis and management of AOM. The
recommendations offer more rigorous diagnostic criteria to reduce
unnecessary antibiotic use.
According to the guidelines, management of AOM should include
an assessment of pain. Analgesics, particularly acetaminophen
and ibuprofen, should be used to treat pain whether antibiotic
therapy is or is not prescribed.
Amoxicillin is recommended for initial empiric therapy because it is
inexpensive, effective, and convenient to administer. Higher
dosages can provide expanded coverage of resistant
Streptococcus pneumoniae.

Surgical management of AOM

Tympanocentesis is the removal of fluid from

behind the eardrum. The doctor uses a special
needle with a tube attached to collect the sample of
fluid.
Myringotomy a surgical procedure of the eardrum
or tympanic membrane is performed by making a
small incision with a myringotomy knife through the
layers of tympanic membrane.
Myringotomy with insertion of a ventilating
tube permits the incised drum to remain open and
allows better drainage of middle-ear fluid.

Possible Complications

Mastoiditis (an infection of the bones around the

skull)

Meningitis (an infection of the brain)

Cholesteatoma (an abnormal collection of skin
cells inside the ear )

Problems with speech and language development

Facial paralysis

Brain abscess

Thank You!