Conditions of the external and middle ear: an overview of presentation, management and associated complications

2017 ◽  
Vol 103 (1) ◽  
pp. 49-55
Author(s):  
R Shukla ◽  
R Easto ◽  
R Williams
Keyword(s):  
Primary Care ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Externa ◽  
Acute Otitis Media ◽  
Suppurative Otitis Media ◽  
Appropriate Treatment ◽  
Military Patients ◽  
Nose And Throat

AbstractEar, nose and throat (ENT) presentations to primary care are common and frequently affect military patients. Many patients can be managed in primary care with appropriate treatment, but some presentations require appropriate, timely, and occasionally emergency onward referral for hospital management. This paper discusses the management of common otological presentations including otitis externa (OE), acute otitis media, chronic suppurative otitis media (including cholesteatoma), tympanic membrane (TM) perforations and pinna haematoma.

scholarly journals Relationship between Acute Suppurative Otitis Media and Chronic Secretory Otitis Media: Role of Antibiotics

1984 ◽  
Vol 77 (9) ◽  
pp. 754-757 ◽  
Author(s):  
Robert Mills ◽  
Ann Uttley ◽  
Michelle McIntyre
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Secretory Otitis Media ◽  
Sensitivity Testing ◽  
Suppurative Otitis Media ◽  
In Vitro Sensitivity ◽  
Resistance To Penicillin

A total of 204 chronic middle ear effusions from 122 children have been studied. Bacteria were isolated from 30 effusions. The commonest species found were Strep. pneumoniae and H. influenzae. These are also the commonest organisms causing acute otitis media (AOM). A similar pattern of serotypes was also demonstrated. In vitro sensitivity testing showed that most of the organisms isolated were sensitive to most commonly-used antibiotics. The main exception was resistance to penicillin amongst strains of H. influenzae and Staph. aureus. It is suggested that some cases of chronic secretory otitis media (SOM) may arise as a result of incomplete resolution of AOM and that the use of penicillin to treat AOM may be one factor in this process.

scholarly journals The management of acute otitis media

1984 ◽  
Vol 22 (14) ◽  
pp. 53-54
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Clinical Examination ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Infectious Complications ◽  
Middle Ear Effusion ◽  
Suppurative Otitis Media ◽  
Painful Condition ◽  
Ear Effusion

Acute suppurative otitis media (AOM) is a common, painful condition affecting 20% of children under 4 years at least once a year,1 and perhaps more in infancy when clinical examination is most difficult. Infectious complications such as mastoiditis, meningitis and cerebral abscess are now rare, but chronic middle ear effusion and hearing loss remain common. Hearing loss may persist long after the infective episode,2 and may impair learning.

Acute Suppurative Otitis Media

PEDIATRICS ◽  
1975 ◽  
Vol 56 (2) ◽  
pp. 285-294
Author(s):  
D. Stewart Rowe
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Pathogenic Bacteria ◽  
Acute Otitis Media ◽  
Polymorphonuclear Cells ◽  
Secretory Otitis Media ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media ◽  
Middle Ear Fluid ◽  
Purulent Fluid

Most pediatricians recognize and treat acute otitis media several times each day. Yet there is wide disagreement about certain aspects of its diagnosis and treatment, despite a large and growing literature on the subject. This review attempts to summarize what is known about acute otitis media in children. DEFINITION Acute suppurative otitis media is distinguished from secretory (serous) otitis media by the presence of purulent fluid in the middle ear. Pathogenic bacteria may be cultured from the majority of needle aspirates of this purulent fluid. In secretory otitis media, relatively few polymorphonuclear cells are present in the middle ear fluid, which is either thin and straw-colored (serous) or thick and translucent grey (mucoid). The fluid has the chemical characteristics either of a transudate of plasma or of a mucoid secretion, presumably produced by goblet cells and mucous glands which are greatly increased in the middle ear mucosa of patients with secretory otitis media. Cultures of this middle ear fluid are usually negative for pathogenic bacteria and viruses. Suppurative otitis media can be diagnosed positively only by aspiration of purulent fluid from the middle ear, but this procedure is rarely necessary for initial diagnosis and management. Clinical findings helpful in distinguishing suppurative from secretory otitis media are discussed below. INCIDENCE In a study of 847 British children during the first five years of life, 19% had at least one episode of otitis media; one third of these had more than one episode. This was considered to be a minimal estimate in these children, since otorrhea was the chief criterion for diagnosis.

Pseudomonas Otitis Media after Eustachian Tube Obstruction

1992 ◽  
Vol 107 (4) ◽  
pp. 511-515 ◽  
Author(s):  
Patrick J. Antonelli ◽  
Steven K. Juhn ◽  
Marcos V. Goycoolea ◽  
G. Scott Giebink
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Suppurative Otitis Media ◽  
Tube Obstruction ◽  
Colony Forming Units ◽  
Tube Function ◽  
Pseudomonas Infection

Previous experiments have shown that Pseudomonas aeruginosa may infect the middle ears of chinchillas by way of the eustachian tube and that chinchillas with acute otitis media (AOM) are more susceptible to pseudomonas infection than animals without AOM. The purpose of this experiment was to examine the effects of otitis media with effusion (OME), induced by means of eustachian tube obstruction, on middle ear susceptibility to nasal inoculation of P. aeruginosa. Chinchilla eustachian tubes were obstructed with silicone rubber sponge bilaterally; OME developed in eight animals (11 ears)—three bilaterally and five unilaterally—and persisted for 6 months. Ten chinchillas with normal eustachian tube function served as controls. All animals were nasally inoculated with 5 times 104 colony-forming units of P. aeruginosa. Pseudomonas otitis media developed in eight of 11 OME ears with effusion, none of five ears without OME, and four of 20 control ears (X2 = 11.782, p = 0.003). Therefore, P. aeruginosa can infect the middle ear by way of the eustachian tube. Tubal dysfunction may lead to the development of chronic suppurative otitis media by increasing tubotympanic susceptibility to opportunistic pathogens.

Temporal bone osteomyelitis and temporoparietal abscess secondary to malignant otitis externa

2009 ◽  
Vol 123 (11) ◽  
pp. 1288-1291 ◽  
Author(s):  
B Alva ◽  
K Chandra Prasad ◽  
S Chandra Prasad ◽  
S Pallavi
Keyword(s):  
Temporal Bone ◽  
Otitis Media ◽  
World Literature ◽  
Otitis Externa ◽  
Acute Otitis Media ◽  
Suppurative Otitis Media ◽  
The Past ◽  
Modified Radical Mastoidectomy ◽  
Malignant Otitis Externa ◽  
Canal Wall Down

AbstractObjective:We report an advanced presentation of osteomyelitis of the temporal bone secondary to malignant otitis externa.Method:We present a case report and a review of the world literature concerning osteomyelitis of the temporal bone secondary to malignant otitis externa.Results:A 60-year-old diabetic man developed osteomyelitis of the temporal bone and a temporoparietal abscess as advanced complications of malignant otitis externa. He was successfully treated in our institution using a post aural incision after draining the abscess and excising the fistula, a modified radical mastoidectomy with canal wall down procedure with sequesterectomy and debridement of surrounding area done.Conclusion:The terms ‘osteomyelitis of the temporal bone’, ‘skull base osteomyelitis’ and ‘malignant otitis externa’ have not been clearly defined, and have in the past often been used interchangeably in the literature. Osteomyelitis of the temporal bone can occur secondary to malignant otitis externa, acute otitis media, chronic suppurative otitis media or trauma. Here, we present the management of an advanced case of osteomyelitis of the temporal bone.

scholarly journals POLA BAKTERI AEROB PADA PASIEN DENGAN DIAGNOSIS OTITIS MEDIA SUPURATIF AKUT DI POLIKLINIK THT-KL RSUP. PROF. DR. R. D. KANDOU MANADO

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Nur Dinih Mamonto ◽  
John Porotu’o ◽  
Olivia Waworuntu
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Bacterial Species ◽  
Acute Otitis Media ◽  
Enterobacter Cloacae ◽  
Proteus Vulgaris ◽  
Biochemical Tests ◽  
Suppurative Otitis Media ◽  
Purposive Sampling ◽  
Tract Infections

Abstract: Otitis media is an inflammation of part or all of the middle ear mucosa. Eustachi tube obstruction is a basic causative factor in acute otitis media. The tract infections can cause swelling around the channel, crunch, and as a result formed pus in the middle ear. The purpose of research is to determine the pattern of aerobic bekteri in patients diagnosis of Acute suppurative otitis media in Polyclinic Hospital THT-KL. PROF. dr. R. D. Kandou Manado. This study is a descriptive study population of all patients in the diagnosis of acute suppurative otitis media by making a purposive sampling technique obtained 20 samples of patients with acute suppurative otitis media. Then, 20 samples were collected for microbiological examination by culture techniques and biochemical tests. The results of this study were 20 patient samples obtained Acute suppurative otitis media age 0-5 years (8 samples; 42%), 6-10 years (6 samples; 27%), 11-20 years (1 sample; 5%), ≥ 20 years (5 samples; 26%); male gender - male (9 samples; 55%), women (9 samples; 45%). Twenty samples examined, all showed growth of bacteria and obtained seven bacterial species and one species of candida. 3 obtained from the gram-positive bacteria, namely Streptococcus sp culture (7 samples; 35%), Staphylococcus sp (4 samples; 20%), Bacilus subtilis (2 samples; 10%) 4 gram-negative bacteria Enterobacter Aglomerans (2 samples; 10% ), Enterobacter cloacae (1 sample; 5%), Seretia Rubidaea (1 sample; 5%), Proteus vulgaris (2 samples; 10%), Candida (1 sample; 5%). Conclusion The research found most bacteria causing acute suppurative otitis media, namely Streptococcus, the largest age group experienced acute suppurative otitis media, namely children’s (0-5 years).Keywords: acute suppurative otitis media, aerobic bacteriaAbstrak: Otitis media adalah peradangan sebagian atau seluruh mukosa telinga tengah. Obstruksi tuba eustachi merupakan suatu faktor penyebab dasar pada otitis media akut. Infeksi di saluran tersebut dapat menyebabkan pembengkakan di sekitar saluran, tersumbatnya saluran, dan sebagai hasilnya terbentuklah nanah dalam telinga tengah. Tujuan penelitian adalah untuk mengetahui pola bekteri aerob pada pasien diagnosis Otitis Media Supuratif Akut di Poliklinik THT–KL RSUP. PROF. dr. R. D. Kandou Manado. Penelitian ini merupakan penelitian deskriptif dengan populasi seluruh pasien yang di diagnosis Otitis Media Supuratif Akut dengan teknik pengambilan purposive sampling didapatkan 20 sampel penderita Otitis Media Supuratif Akut. Kemudian, 20 sampel dikumpulkan untuk dilakukan pemeriksaan mikrobiologi dengan teknik kultur dan uji biokimia. Hasil dari penelitian ini adalah 20 sampel pasien Otitis Media Supuratif Akut didapatkan umur 0 – 5 tahun (8 sampel; 42%), 6 - 10 tahun (5 sampel; 27%), 11 – 20 tahun (1 sampel; 5%), ≥ 20 tahun (5 sampel; 26%); jenis kelamin laki – laki (9 sampel; 55%), perempuan (9 sampel; 45%). Duapuluh sampel yang diperiksa, seluruhnya menunjukkan pertumbuhan bakteri dan didapatkan 7 spesies bakteri dan 1 spesies candida. Didapatkan 3 bakteri gram positif dari hasil kultur yaitu Streptococcus sp (7 sampel; 35%), Staphylococcus sp (4 sampel; 20%), Bacilus subtilis (2 sampel; 10%) 4 bakteri gram negatif Enterobacter Aglomerans (2 sampel; 10%), Enterobacter cloacae (1 sampel; 5%), Seretia Rubidaea (1 sampel; 5%), Proteus Vulgaris (2 sampel; 10%), Candida (1 sampel; 5%). Kesimpulan penelitian didapatkan bakteri terbanyak penyebab Otitis Media Supuratif Akut yaitu Streptococcus,dan kelompok umur terbanyak yaitu anak – anak (0 – 5 Tahun).Kata kunci: otitis media supuratif akut, bakteri aerob

scholarly journals Acute Mastoiditis in Children: Susceptibility Factors and Management

2007 ◽  
Vol 7 (2) ◽  
pp. 129-133 ◽  
Author(s):  
Slobodan Spremo ◽  
Biljana Udovčić
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Acute Mastoiditis ◽  
Middle Ear Mucosa ◽  
Susceptibility Factors ◽  
Intravenous Antibiotics ◽  
Intracranial Complications

The objective was to review our experience with clinical course, diagnostic and therapeutic profile of children treated for acute mastoiditis, and to investigate for possible susceptibility factors. Study was designed as retrospective review of pediatric patients presenting with acute mastoiditis secondary to acute otitis media over the last 6 years, from 2000 to 2006. The study involved children aged from 1 to 16 years treated for acute mastoiditis and subsequent intratemporal and intracranial complications in Clinic for otorhinolaryngology, Clinic Center Banja Luka. Selected clinical parameters, mastoid coalescence and risk factors for necessity of surgical intervention were analyzed. Medical history review of a total of 13 patients with acute mastoiditis was analyzed. Acute coalescent mastoiditis occurred 11 patients (84%) while noncoalescent form of acute mastoiditis occurred in 2 cases (16%). Intracranial complication occurred in 3 patients (2 meningitis and 1 peridural intracranial abscess), while 2 patients had intratemporal complication (subperiostal abscess) associated to coalescent mastoiditis. We observed clinical profile of acute mastoiditis in regard to pathology found on the tympanic membrane, middle ear mucosa and destructions on the bony wall of the middle ear and mastoid. The main signs of progressive infection were tympanic membrane perforation, pulsatile suppurative secretion from the mucosa, and intratemporal abscess. All patients with coalescent mastoiditis required mastoidectomy, while noncoalescent mastoiditis was treated conservatively with broad-spectrum intravenous antibiotics and myringotomy. In conclusion acute mastoiditis is uncommon but serious complication of acute otitis media in children associated with significant morbidity. Coalescent mastoiditis concomitant with subperiostal abscess, intracranial complications and mastoiditis not responsive after 48 hours to intravenous antibiotics should urge clinician to timely mastoid surgery.

Dilemmas in Primary Care: Antibiotic Treatment of Acute Otitis Media

1986 ◽  
Vol 20 (9) ◽  
pp. 666-669 ◽  
Author(s):  
Bev Lorraine True ◽  
Dennis K. Helling
Keyword(s):  
Primary Care ◽  
Antibiotic Therapy ◽  
Otitis Media ◽  
Antibiotic Treatment ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Rational Approach ◽  
Recurrence Rates ◽  
Middle Ear Fluid ◽  
Initial Antibiotic Therapy

Antibiotic treatment of acute otitis media (AOM) accounts for a significant number of all antibiotic prescriptions each year. In the primary care setting, initial antibiotic selection is rarely based on direct evidence, such as cultures of middle ear fluid. Initial antibiotic therapy by the primary care practitioner involves the evaluation and application of information related to prevalence of infecting organisms; in vitro antibiotic spectrum and penetration into middle ear fluid; initial cure rate, relapse and recurrence rates; and antibiotic cost, safety, and convenience. The influence of these factors on the initial antibiotic choice for AOM is reviewed. Several therapeutic dilemmas confronting the prescriber are discussed and a rational approach to initial antibiotic therapy is presented.

Tympanosclerosis: review of literature and incidence among patients with middle-ear infection

1999 ◽  
Vol 113 (12) ◽  
pp. 1076-1080 ◽  
Author(s):  
Saad Asiri ◽  
Alaa Hasham ◽  
Fatma Al Anazy ◽  
Siraj Zakzouk ◽  
Adel Banjar
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Clinical Picture ◽  
Pure Tone ◽  
Chronic Suppurative Otitis Media ◽  
Review Of Literature ◽  
Suppurative Otitis Media ◽  
Middle Ear Infection

AbstractThe aim of the study was to review the literature of tympanoscierosis especially its pathogenesis, to study the general incidence of tympanoscierosis among patients with chronic suppurative otitis media (CSOM), its association with cholesteatoma and also the type of hearing loss as well as its relation to the degree and site of tympanosclerosis.Seven hundred and seventy-five patients with CSOM were studied retrospectively. A full history was taken and thorough ENT examinations were carried out. Pure tone audiograms (PTA) of all patients were done and analysed. The operative finding of tympanosclerosis as well as middle-ear status were inspected.The incidence of tympanosclerosis was found to be 11.6 per cent (90 patients out of 775 CSOM cases). Most tympanosclerosis cases had dry ear, (85.6 per cent). Of the 57.8 per cent who had myringosclerosis, their PTA showed an AB gap 20–40 dB. When sclerosis affect both the tympanic membrane and middle ear, 61 per cent of patients had an AB gap >40 dB. The association of cholesteatoma and tympanosclerosis may be regarded as uncommon, 2.2 per cent.The exact aetiology and pathogenesis of tympanosclerosis is as yet not well known. Our study concentrated on the clinical picture of tympanosclerosis among patients with CSOM. The majority of hearing loss associated with tympanosclerosis was of the conductive type.

scholarly journals Inflammatory cast of the tympanic membrane after acute otitis media

2013 ◽  
Vol 127 (3) ◽  
pp. 314-317
Author(s):  
J Byun ◽  
DS Massi ◽  
A Sehgal ◽  
M Saadia-Redleaf
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Primary Care Physicians ◽  
Otitis Externa ◽  
Chart Review ◽  
Acute Otitis Media ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Patient Treatment

AbstractObjective:To describe a relatively unknown clinical entity – inflammatory cast of the tympanic membrane after acute otitis media – and its simple out-patient treatment.Study design:Retrospective review of case series.Setting:Subspecialty practice at a tertiary hospital.Patients:Seven patients diagnosed previously with acute otitis media with perforation or otitis externa, and with persistent ear discomfort.Methods:Retrospective chart review.Results:The patients presented with weeks to months of persistent hearing loss after acute otitis media with perforation or acute otitis externa. Visits to their primary care physicians had been uninformative. After comparison of the affected and unaffected tympanic membranes, a thin, hard cast was identified and removed from the affected tympanic membrane. Improvement in hearing was documented in the three patients who underwent audiometric testing; the remainder had subjective improvement without audiometric evaluation.Conclusion:Otolaryngologists should be aware of the possibility of an inflammatory cast of the tympanic membrane following acute otitis media with perforation or otitis externa, and should carefully compare the unaffected and affected ears in such cases. Treatment – removal of the rigid cast – is both simple and effective.

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