Risk Factors

-Frequent Respiratory Infections, such as flu, sore throat, colds (Smeltzer and Bare, 2004) -Trauma to middle ear: acoustic trauma related to work environment (Lonsbury-Martin BL, Martin GK., 2010) -Extensive exposure to air pollution and smoke ( Brauer et. al, 2006) -Recurrent otitis media (Smeltzer and Bare, 2004) -Non-compliance to antibiotic regimen (Acuin, 2004; Smeltzer and Bare, 2004) Trauma causing inflammation Obstruction of ear canal Eustachian Tube dysfunction Recurrent respiratory infections and smoke Microbes enter eustachian tube from contaminated Invades middle ear Poor aeration in epitympanic space Increase in negative pressure
Tympanic membrane becomes retracted into middle ear space (Smeltzer and Bare, 2004) Retraction Pocket Formed

Sound vibrations enter middle ear through perforation (Acuin, 2004) Strikes oval and round window No lag time between oval and round window

Tympanic Membrane perforation

Squamous Epithelium migrates towards perforated edges

Continues to grow medially along the under surface of the ear drum (Hauptman and Makishima, 2006)

Abscess formation Purulent exudate

Systemic Infection: Fever (Smeltzer and Bare, 2004)

Hearing loss (Smeltzer and
Bare, 2004)

Foul –smelling otorrhea
(Acuin, 2004)

Skin (cholesteatoma) fills with degenerated skin and sebaceous Sac attaches to structures in middle ear or mastoid

Ear pain (Smeltzer and
Bare, 2004) 11111 13

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