Otitis Media

OTITIS MEDIA• Otitis media (Latin) is inflammation of the middle ear, or

a middle ear infection.

• It occurs in the area between the tympanic membrane and the inner ear, including a duct known as the eustachian tube

Otitis media

Otitis media

Manifestations

• Babies and toddlers

-pulling or scratching at the ear

-hearing problems

-fever

-drainage from the ear

-irritability

- vomiting.

• Older children and adults

-earache

-hearing problems

-fullness or pressure in the ear

-fever

-drainage from the ear

-dizziness and loss of balance

-nausea or vomiting.

Etiology

• Allergy-food and airborne• Infection-bacteria and viruses i.e.

Streptococcus pneumoniae, Haemophilus influenzae and moraxella catarrhalis.

• Blockage of the eustachian tube-swollen tonsils or adenoids or problems involving the bones of the cranium

• Nutritional deficiency-vitamin A, zinc and iron deficiencies

Diagnosis:

• Otoscope- use to directly examine the ear• Audiogram- used to measure how much

hearing loss has occurred• Tympanogram- measures the air pressure

in the middle ear; this indicates how well the eustachian tube is functioning

• Obtaining culture from the middle ear through the ear drum This is usually done by an otolaryngologist.

Medical managementAge Certain diagnosis Uncertain diagnosis

<6 months Antibiotics Antibiotics

6 months-2years Antibiotics Antibiotics if severe illness; *Observation without antibiotics option if non-severe illness

≥2 years Antibiotics if severe illness; *Observation option if non-severe illness

*Observation option without antibiotics

Non-severe illness is represented by mild ear pain and fever <39 C (102.2 F) in the past 24 hours. Severe illness is moderate to severe otalgia (ear pain) or fever 39 C. If antibiotics are initiated, amoxicillin is usually recommended as the first line treatment.

Surgical Management

• Myringotomy- An otolaryngologist makes a small incision in the eardrum and inserts a tiny ventilation tube called a tympanostomy tube. The tube promotes drainage of fluid from the middle ear and keeps it from recurring

• Adenoidectomy- Removal of the adenoids (adenoidectomy)

• Tonsillectomy. Removal of the tonsils (tonsillectomy).

Nursing management:

• Responsibility of the nurse

-local heat (hot water bottle).

-cleanliness of the ear canal by sterile cotton cones moistened with physiologic saline or H2O2,then the ear is wiped dry with sterile cotton .

-care of the skin around the ear