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ALGORITHM

CHRONIC SUPPURATIVE OTITIS MEDIA

URTI

Ascending Bacterial (S. pneumoniae, H. influenzae)


↑bacterial invasion Via Eustachian tube
colonization

↓mucocilliary Risk factor:


defense Eustachian tube dysfunction
Pre-school age

(anatomical
Net negative pressure in the middle ear and immune
sytem)

Free entry of pathogens to the middle ear

Bacterial aggregation and mucosal damage

Edema and exudates in the middle ear

Pus formation and build up

Conductive hearing
Perforation of the tympanic membrane
loss

Otorrhea Outflow of mucopurulent discharge through the


perforated TM

Non-healing TM and repeated inflammation

CHRONIC SUPPURATIVE OTITIS MEDIA

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