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Otitis Media

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ARUN on Oct 08, 2009 Says :

excellent

JAYSHNAQ on Aug 30, 2009 Says :

Nice Slides

james featherhead on Jul 27, 2009 Says :

Thanks a lot for sharing this presentation.it is extremely informative and very well explained.helped me a lot in understanding the subject.

goli on Jun 19, 2009 Says :

hi this is the best

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Show Notes

Slide 1 :

Otitis Media By James A. Yost, M.D., MS, M.B.A. Emory Family Medicine

Slide 2 :

Otitis Media Acute Chronic Definition Epidemiology Risk Factors Microbiology Complications Diagnosis Treatment

Slide 3 :

Otitis Media Otitis Gr. otos, ear, + itis, inflammation Media Referrs to the middle portion of the ear Definition any inflammation of the middle ear without reference to etiology or pathogenesis

Slide 4 :

Slide 5 :

Acute Otitis Media

Slide 6 :

Acute Otitis Media Definition Onset less than 3 weeks Epidemiology In the U.S. 20,000,000 cases of AOM are estimated to occur each year. By age 12 months, 66% of all children have had at least one episode of AOM By age 3 years, 46% of children had 3 or more episodes of AOM

Slide 7 :

Acute Otitis Media Epidemiology cont. 2nd most common disease of Childhood the most common cause for childhood visits to a physician's office Highest incidence of AOM occurs between 6 and 24 months of age much less common after 7 years of age

Slide 8 :

Acute Otitis Media Risk Factors Day care Winter months Craniofacial anomalies Congenital or acquired immune dysfunction Eustachian tube dysfunction Ciliary dysfunction Allergies Cigarette smoke and air pollution Nasal obstruction

Slide 9 :

Acute Otitis MediaBugs!! Bacteria S. pneumoniae (35%) H. influenzae (25%) M. catarrhalis (15%) Gram negative enteric bacteria (25%) Viruses Respiratory syncytial virus Adenovirus Rhinovirus Influenza virus

Slide 10 :

Acute Otitis Media Complications Persistent middle ear effusions 40% have effusion at one month 20% at two months 10% at three months Hearing loss (conductive and sensory) TM perforation

Slide 11 :

Acute Otitis Media Complications cont. Chronic suppurative otitis media Atelectasis Cholesteatoma Tympanosclerosis Mastoiditis Meningitis Labyrinthitis

Slide 12 :

Acute Otitis Media Diagnosis Otalgia Ear tugging Otorrhea Hearing loss Fever, irritability, anorexia, N/V, diarrhea, lethargy, headache Tinnitus, vertigo

Slide 13 :

Acute Otitis Media Diagnosis cont. Physical exam with an otoscope: Opacity Bulging TM Erythema Middle ear effusion (MEE) Decreased mobility with pneumatic otoscopy

Slide 14 :

Acute Otitis Media

Slide 15 :

Acute Otitis Media

Slide 16 :

Acute Otitis Media

Slide 17 :

Acute Otitis Media

Slide 18 :

Acute Otitis Media Treatment The ABCDEFs of treating AOM Amoxicillin/Augmentin Biaxin/Bactrum Cephalosporins Diet/hydration Erythromycin Fever control

Slide 19 :

Chronic Otitis Media Definition Greater than 3 months Chronic serous otitis media may be defined as a middle ear effusion, having the nature of serum Chronic suppurative otitis media is a middle ear effusion having an agent producing pus formation

Slide 20 :

Chronic Otitis Media Epidemiology 39 cases per 100,000 persons in children and adolescents aged 15 years and younger 8% of American Indians 12% of Eskimos

Slide 21 :

Chronic Otitis Media Risk Factors A history of multiple episodes of AOM Living in crowded conditions Day care facility attendance Being a member of a large family Ciliary dysfunction Chronic Allergies Cigarette smoke and air pollution Nasal obstruction from adenoids

Slide 22 :

Chronic Otitis Media Bacteria P. aeruginosa (40%) S. aureus (20%) Klebsiella (20%) Anaerobes are found in 50% of cases

Slide 23 :

Chronic Otitis Media Diagnosis A common presenting complaint is hearing loss in the affected ear Fever or vertigo The external auditory canal may or may not be edematous and typically is not tender. The discharge of purulent, and cheeselike to clear and serous.

Slide 24 :

Chronic Otitis Media Diagnosis cont. Granulation tissue often is seen The middle ear mucosa may be edematous or even polypoid, pale, or erythematous. CT scan or MRI

Slide 25 :

Chronic Otitis Media

Slide 26 :

Chronic Otitis Media

Slide 27 :

Chronic Otitis Media Treatment Chemoprophylaxis Myringotomy and tubes: 4 episodes of AOM in six months 6 episodes a year Or no response to treatments Adenoidectomy Pneumococcal vaccines

Slide 28 :

Chronic Otitis Media Treatment cont. Topical antibiotic drops containing aminoglycosides Intranasal or systemic decongestants Systemic antihistamines Systemic or intranasal steroids

Slide 29 :

Chronic Otitis Media

Slide 30 :

Chronic Otitis Media

Slide 31 :

Chronic Otitis Media Myringotomy tubes.wmv Click here for a video of a myringotomy

	jyostmd@hotmail.com 1 Years ago. Category: Family Medicine

Tags:	Family Medicine

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