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Acute otitis media - Coggle Diagram
Acute otitis media
Otitis media with effusion (painless)
causes
Inflammatory response after AOM
Spontaneously >>> poor ET function
related clinical condition
Allergic edema
Sinusitis
Cleft palate
Rhinitis
Adenoiditis
viral infection
Iatrogenic (post-adenectomy)
Diagnosis
History
Deficient hearing
Recurrent ASOM with earache
Clinical examination
otoscope (diagnostic)
fluid level (bulging valsalva)
limited mobility
Retracted TM
radiological
Plane X-ray >>> adenoid
CT >>> nasopharynx
TM
Opaque
yellow color
loss of land mark (cone of light & umbo)
fluid line
Tympanometry
Flat type B (confirmatory)
Complication
Developmental and behavioral changes
Atrophic TM
Chronic OM
Ossicular chain erosion
Sequel (if untreated)
ME atelectasis
adhesive OM
Cholesterol granuloma
Tympanosclerosis
Management
Medical
Antihistaminic
C.steroids
AB
ET ventilation as: valsalva, gum chewing
Surgical
Myringotomy + ventilator tube
Surgery to the related conditions as adenoidectomy
Notes
TM perforation healing
Spontaneous healing
Tympanoplasty
Hemotympanum
Intact Tm with bluish background
Imaging is a must
Complication
Chronic OM
Silent OM
Permenant conductive hearing loss (CHL)
Cranial complication
Permenant tempanic membrane perforation
Intracanial complication
Silent OM
Etiology
Sequels
Drum retraction & atelectasis
Masked mastooiditis
Adhesive OM
COM
Middle ear effusion
Intra cranial complication
Treatment
myringotomy
mastoidectomy
AB
Diagnosis
Otoscopy (anatomical)
tympanometry (function)
Clinical picture
Masked OM
Subclinical OM
concealed OM
Classification
acute suppurative OM
acute necrotizing OM
acute viral OM
acute allergic OM
Route of infection
Drum perforation
Retrograde (meningitis and labyrinthitis)
Eustachain tube
Blood borne
dis of childhood and infancy
Anatomical factor
Eustacian tube
Adenoiditis, chronic tonsillitis (foci of infection)
Physiological factor
Faulty positioning of the infant (milk otitis)
Decreased resistance (teething)
Treatment
Medical
Before
Decongestant
broad spectrurm AB
anti.inflammatory
After
AB guided culture sensitivity
surgical (Maryrngotomy)
Thick TM in children
complication appears (facial palsy)
Pending peforation
Acute necrotizing OM
Treatment
IM gamma-globulin
surgery
AB
refer OM to otologist
Abnormal TM in otoscopy
Treatment failure
Difficult otoscopy (waxy, narrow canal , hairy canal)
Starts complications
causative organism
pathogenesis
clinical picture