![Page 1: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/1.jpg)
Medical Diagnostics, Otitis Media, & OtosclerosisOzarks Technical Community CollegeHIS 125
![Page 2: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/2.jpg)
Medical Diagnostics • Lab/Blood work• Imaging• CT Scan
• Best at visualizing bony structures• Ossicles• Bony labyrinth• Temporal bone
• MRI• Best at visualizing soft tissues• Auditory nerve• Brainstem/brain
![Page 3: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/3.jpg)
Otitis Media
• Definition: inflammation of the middle ear• Cause: usually bacterial; often accompanies/follows a cold,
sore throat, or upper respiratory infection• Treatment: antibiotics, tubes if OM is chronic and not
successfully responsive to medical treatment
• More common in children (especially those <2 yo) due to smaller and more horizontal eustachian tubes and weaker immune systems• 90% of children in US will have at least one case of OM before
age 6
![Page 4: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/4.jpg)
Common Symptoms in Children
• Tugging or pulling at the ear(s) • Fussiness and crying • Trouble sleeping • Fever (especially in infants and younger children) • Fluid draining from the ear • Clumsiness or problems with balance • Trouble hearing or responding to quiet sounds
• *Increased risk in children who are bottle-fed, use a pacifier, exposed to smoke, attend group daycare
Source: nidcd.nih.gov
![Page 5: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/5.jpg)
Common Symptoms in Adults• Pain• Pressure• Popping/crackling• Drainage• Hearing loss• Tinnitus• “I feel like I have water stuck in my ear”• “My ear feels like it needs to be popped”
![Page 6: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/6.jpg)
Otitis Media• Classified by type and duration of symptoms:• Type
• 1. OM without effusion (fluid)• 2. OM with effusion• 3. OM with perforation of tympanic membrane
• Duration• 1. Acute (0-21 days)• 2. Subacute (22 days-8 weeks)• 3. Chronic (>8 weeks)
![Page 7: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/7.jpg)
Types of Effusion• 1. Serous• Watery, sterile
• 2. Purulent• Pus-like, infected
• 3. Mucoid• Thick mucus
![Page 8: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/8.jpg)
Serous OM
http://wps.prenhall.com/chet_martin_audiology_11/194/49689/12720513.cw/index.html
![Page 9: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/9.jpg)
Purulent OM• Note the pus-like fluid in the upper half of the middle ear
(Image courtesy of Hawke Library)
![Page 10: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/10.jpg)
Mucoid OM• This left tympanic membrane appears
to be normal; however, on careful inspection you’ll see that the middle ear is filled with a gray fluid.
• Mucoid fluid that was drained from a middle ear
• Images courtesy of Hawke Library
![Page 11: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/11.jpg)
Audiometric Findings in OM• Otoscopy• May see obvious signs of inflammation, redness• May see fluid and/or retraction of the TM
• Tympanometry• Most commonly you will find significant negative pressure (Type
C) or an immobile TM/flat tymp (Type B)• Audiometry• Slight-to-mild conductive hearing loss
![Page 12: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/12.jpg)
If left untreated…• Permanent HL• Perforated TM• Mastoiditis• Cholesteatoma• Ossicular discontinuity• Tympanosclerosis
(scarring of TM)• Meningitis• Encephalitis• Brain abscess
Tympanosclerosis(Image courtesy of Hawke Library)
![Page 13: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/13.jpg)
Otosclerosis• Occurs when excessive bone grows around the stapes
footplate and fixates the stapes to the oval window• Results in a conductive component to hearing loss• Often hereditary, more common in women• Usually bilateral• Occurs most commonly in 30s or 40s (may occur after
childbirth)
![Page 14: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/14.jpg)
Common Symptoms of Otosclerosis• Hearing loss• Tinnitus
![Page 15: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/15.jpg)
Audiometric Findings in Otosclerosis• Otoscopy• Usually WNL (within
normal limits)• May see Schwartze’s
sign=reddish and/or bluish coloration on TM
• Tympanometry• Most commonly you will
find either normal middle ear function (Type A) or hypocompliance (Type AS)
• Audiometry• Conductive and/or mixed
hearing loss, often with Carhart’s notch at 2 kHz
Schwartze’s sign (L ear); image courtesty of Hawke Library
![Page 16: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/16.jpg)
Audiogram - Otosclerosis
• Carhart’s notch present at 2kHz
• Note: This patient had normal tympanograms and absent acoustic reflexes
![Page 17: Medical Imaging, Otitis Media, & Otosclerosis](https://reader033.vdocument.in/reader033/viewer/2022052600/5582fffad8b42a121c8b4916/html5/thumbnails/17.jpg)
Treatment for Otosclerosis• Do nothing • Surgery• Stapedectomy (removal of stapes and prosthesis
placement)• Amplification• Usually very easy to fit with a hearing aid(s)
Image from: drmkotb.com