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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 management
Age <6 months 6 months-2years Certain diagnosis Antibiotics Antibiotics Uncertain diagnosis Antibiotics Antibiotics if severe illness; *Observation without antibiotics option if non-severe illness *Observation option without antibiotics

2 years

Antibiotics if severe illness; *Observation option if non-severe illness

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

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