Ministry of Higher University of Diyala

Education
College of Medicine
and Scientific Research

Repot title :
Otitis Media & its complications
Subject name :
Practical anatomy (libratory)
By

Abdullah Essa Raham Jassim

Supervised by

Dr . Duraid Hameed
Dr. Mohaimen Adnan Alwazan
Dr. Reham Saad

2020 AD 1440 AH

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 Introduction
Infections and Otitis Media Pathogenic organisms can gain entrance to the
middle ear by ascending through the auditory tube from the nasal part of the
pharynx. Acute infection of the middle ear (otitis media) produces bulging and
redness of the tympanic membrane.
Otitis media is a build-up of fluid in the middle ear, which is the space
between the eardrum and the inner ear.
Usually, the middle ear is filled with air, but sometimes it gets filled with fluid or
mucus, for example during a cold. If the mucus gets infected with bacteria it
causes an ear infection.

Acute and chronic otitis media

Acute otitis media is a short-term ear infection that often comes on suddenly.
Chronic otitis media is a middle ear infection that lasts for a long time or keeps
coming back.
Otitis media with effusion (OME), also known as glue ear, is common in young
children.

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 Symptoms
Acute otitis media
 severe earache (caused by the pressure of mucus on the eardrum)

 a high temperature (fever) of 38°C (100.4°F) or above

 flu-like symptoms in children, such as vomiting and lethargy (a lack

of energy)
 slight deafness

Chronic otitis media

Compared with acute otitis media, chronic otitis media often has fewer
symptoms or milder versions of them. However, the symptoms last for
a long time or keep coming back. In cases of chronic otitis media there
is also more likely to be pus or fluid coming out of the ear.
Otitis media with effusion
 ear discomfort

 hearing difficulty or hearing loss

 recurring episodes of acute otitis media

 recurring upper respiratory tract infections, which are infections

that affect the nose, sinuses, throat, pharynx (the area at the back
of your throat) and larynx (voice box).

Causes of otitis Media

1. Blocked Eustachian tube
2. Cholesteatoma
3. Weak immune system
4. Small Eustachian tubes
5. Large adenoids
6. Glue ear
7. may also be caused by childhood illnesses, such as measles

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 Complications of Otitis Media

Diagnosis
Ear examination
Otitis media is diagnosed from the condition's symptoms and by examining the
eardrum with an instrument called an auriscope, or otoscope. An auriscope has a
light at one end that is shone into the ear and a magnifying glass so that the doctor
can see inside the ear in more detail.
An auriscope cannot be used to see inside the middle ear, but the doctor can use
it to see whether there is any fluid leaking into the outer ear. It is also possible to
examine the eardrum, which gives some clues as to what is happening inside the
ear.
You may be asked to pinch your nose and close your mouth before gently blowing
out. Alternatively, an instrument may be used to blow a small puff of air into your
ear.
If your Eustachian tube (a tube that passes between your throat and middle ear)
is clear, your eardrum will move slightly. However, if it is blocked, your eardrum
will remain still. The examination will also show whether your eardrum is
perforated (has a hole in it).

The eardrum is usually a pink colour. However, if you have otitis media, your
eardrum is red or yellow, and may look a little lumpy. It may also be bulging
outwards as a result of the pressure of the mucus.

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 Treatment
Antibiotics
Antibiotics will not be prescribed straight away for recurrent acute otitis media
unless you have persistent symptoms or you are likely to be at high risk of
developing complications. If your symptoms worsen, your GP may prescribe a
course of antibiotics.

Over-the-counter medication
Over-the-counter (OTC) painkillers, such as paracetamol and ibuprofen may be
used to control the symptoms of otitis media (pain and fever). Aspirin should
not be given to children who are under 16 years of age.
Nose drops containing decongestants or antihistamines may be used to reduce
the swelling of the mucous membranes in the nose and back of the throat. This
may help to keep the Eustachian tubes clear, and allow mucus to drain from the
middle ear. However, nose drops have not been proven to be an effective
treatment for otitis media.
In adults with long-term (chronic) otitis media, drops containing antibiotic
medication have been shown to help reduce the amount of pus that comes from
the ear.

Tympanostomy tubes (Grommets)

For children with recurrent, severe otitis media, tiny tubes may be inserted
through the eardrum to help drain fluid. These tubes are called grommets or
tympanostomy tubes.
Tympanostomy tubes are not recommended in all cases, as there is a chance
that the grommets may cause other problems. For example, they can become
blocked or infected themselves.

Surgical procedures
There are similar risks for an operation called a myringotomy, which is where a
small hole is made in the eardrum to allow fluid to drain out.
Removal of the adenoids and tonsils (small lumps of tissue that are located at
the back of the throat) may help if they are blocking the entrance to the
Eustachian tube.

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Otitis media with effusion
Antibiotics, steroids, antihistamines and decongestants are not recommended to
treat otitis media with effusion (OME).
If OME has been present for 12 weeks or more, your GP will refer you to an ear,
nose and throat (ENT).

References:
1. Snell Clinical Anatomy by Regions.
2. Claxton K, Ginnelly L, Sculpher M, Philips Z, Palmer S. A pilot study on the use
of decision theory and value of information analysis as part of the NHS Health
Technology Assessment programme. Health Technol Assess 2004;8(31).
10.3310/hta8310.
3. Kalcioglu MT, Cokkeser Y, Kizilay A, Ozturan O. Follow-up of 366 ears after
tympanostomy tube insertion: why is it draining? Otolaryngol Head Neck
Surg 2003;128:560–4. 10.1016/S0194-5998(03)00120-7.
4. Schönweiler R, Lisson JA, Schönweiler B, Eckardt A, Ptok M, Tränkmann J, et
al. A retrospective study of hearing, speech and language function in children
with clefts following palatoplasty and veloplasty procedures at 18–24 months
of age. Int J Pediatr Otorhinolaryngol 1999;50:205–17. 10.1016/S0165-
5876(99)00243-8.
5. Schönweiler R, Schönweiler B, Schmelzeisen R. Hearing capacity and speech
production in 417 children with facial cleft abnormalities. HNO 1994;42:691–6.