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Otitis Media - Coggle Diagram
Otitis Media
Risk Factors
Down syndrome
Cleft palate (craniofacial abnormalities)
Young age
Formula feeding
GORD
Diagnosis
Acute onset earache
On otoscopic examination
Red, yellow or cloudy tympanic membrane
Moderate to severe bulging of tympanic membrane
Perforation of tympanic membrane and/ore discharge in external auditory canal.
In children younger than 6 months diagnosis difficult
Tympanic membrane not always visible
Symptoms are often non-specific
Management
Antibiotic therapy - Amoxicillin or clarithromycin (if pen allergy)
Paracetamol/ibupfrofen for analgesia
Review after 7 days if no improvement
Differential diagnosis
Ottitis media with effusion - Glue ear
Fluid in middle ear with no signs of infection
Chronic supurative otitis media
Chronic inflamation and perforation of tympanic membrane
Myringitis
Erythema of tympanic membrane but no other symptoms
Red flags - Nasopharyngeal cancer (rare)
Persistent cervical lymphadenopathy (usually in the upper levels of the neck)
Epistaxis and nasal obstruction
Persistent symptoms and signs with effusion in between episodes (conducting hearing loss)
Refer to ENT
Suspected acute complications
Facial nerve paralysis
Sinus thrombosis
Children under 3 with temperature above 38 degrees
Adults with persistent symptoms lasting more than 6 weeks.