Otitis Media (OM) :part 1.التهاب الاذن الوسطى: جذء اول

Otitis media: *OTITIS MEDIA(OM) :is a group of inflammatory diseases of the middle ear. Etymology: The term otitis media is composed of otitis, Ancient Greek for "inflammation of the ear", and media, Latin for "middle". The 3 main types are: 1- acute otitis media (AOM) . 2- otitis media with effusion (OME). AOM is an infection of rapid onset that usually presents with ear pain. In young children this may result in pulling at the ear, increased crying, and poor sleep. Decreased eating and a fever may also be present. OME is typically not associated with symptoms. Occasionally a feeling of fullness is described. It is defined as the presence of non-infectious fluid in the middle ear for more than three months. 3- Chronic suppurative otitis media (CSOM) : is middle ear inflammation that results in discharge from the ear for more than three months. It may be a complication of acute otitis media. Pain is rarely present. All three types of otitis media may be associated with hearing loss. The hearing loss in OME, due to its chronic nature, may affect a child's ability to learn. **Acute otitis media : is diagnosed in patients with : 1-acute onset. 2-presence of middle ear effusion. 4-, physical evidence of middle ear inflammation. 4- symptoms such as pain, irritability, or fever. 5- Acute otitis media is usually a complication of eustachian tube dysfunction that occurs during a viral upper respiratory tract infection. Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the most common organisms isolated from middle ear fluid. Signs and symptoms acute otitis media: The primary symptomS of acute otitis media ARE: 1- ear pain. 2- fever,. 3- reduced hearing during periods of illness., 4- tenderness on touch of the skin above the ear,. 5- purulent discharge from the ears,. 6- irritability, and diarrhea (in infants). 7- Since an episode of otitis media is usually precipitated by an upper respiratory tract infection (URTI), there are often accompanying symptoms like a cough and nasal discharge. 8- One might also experience a feeling of fullness in the ear. 9-Discharge from the ear can be caused by: 1- acute otitis media with perforation of the ear drum. 2- chronic suppurative otitis media., 3- tympanostomy tube otorrhea., 4- acute otitis externa. 5- Trauma, such as a basilar skull fracture, can also lead to discharge from the ear due to cerebral spinal drainage from the brain and its covering (meninges). Causes otitis media: 1-The common cause of all forms of otitis media is dysfunction of the Eustachian tube. This is usually due to inflammation of the mucous membranes in the nasopharynx, which can be caused by a viral upper respiratory tract infection (URTI), strep throat, or possibly by allergies. 2-By reflux or aspiration of unwanted secretions from the nasopharynx into the normally sterile middle-ear space, the fluid may then become infected — usually with bacteria. Bacteria can be isolated from middle ear fluid cultures in 50% to 90% of cases of AOM and OME. Streptococcus pneumoniae, Haemophilus influenzae (nontypable), and Moraxella catarrhalis are the most common organisms. H. influenzae has become the most prevalent organism among children with severe or refractory AOM following the introduction of the pneumococcal conjugate vaccine. Risk Factors for Acute Otitis Media: 1-Younger. 2-Allergies. 3-Craniofacial abnormalities. 4-Exposure to environmental smoke or other respiratory irritants. 5-Exposure to group day care. 6-Family history of recurrent acute otitis media. 7-Gastroesophageal reflux. 8-Immunodeficiency. 9-No breastfeeding. 10-Pacifier use. Upper respiratory tract infections. Causes of otitis media: 1-The common cause of all forms of otitis media is dysfunction of the Eustachian tube.This is usually due to inflammation of the mucous membranes in the nasopharynx, which can be caused by a viral upper respiratory tract infection (URTI), strep throat, or possibly by allergies. 2-By reflux or aspiration of unwanted secretions from the nasopharynx into the normally sterile middle-ear space, the fluid may then become infected — usually with bacteria. The virus that caused the initial upper respiratory infection can itself be identified as the pathogen causing the infection. Diagnosis: 1-diagnosis of acute otitis media: As its typical symptoms overlap with other conditions, such as acute external otitis, 1-symptoms alone are not sufficient to predict whether acute otitis media is present; it has to be complemented by visualization of the tympanic membrane. 2-Examiners may use a pneumatic otoscope with a rubber bulb attached to assess the mobility of the tympanic membrane. 3- Other methods to diagnose otitis media is with a tympanometry, reflectometry or hearing test.

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