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characteristics otitis media
- 1/4 of children have this
- secondary disease caused by eustachian tube not the ear
- 99% of ppl with cleft palate have this
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otitis media steps
- 1 - URI / blocked tube - air cannot get out
- 2 - fluid build up - causes blockage, negative pressure, sterile fluid which is bacteria heaven
- 3 - infection - bacteria get in and breed, immune system kills it and creates puss, puss pushes on ear drum and hurt extremely bad
- 4 - perforation - ear drum breaks, puss releases
- 5 - TM heals and repeats?
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otitis media is caused
because E-tubes are immature
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why are antibiotics not used
because they stop the process in the middle and leave build up in the middle ear - not good
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classification by pathology
- purulent / suppurative - ear full of infection
- nonpurulent / nonsuppurative - ear full of sterile fluid
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classification by fluid
- serous - wet, watery fluid
- secretory / mucoid - thick, goey puss, long term
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classification by time
- Acute (AOM) - happening now
- Recurrent - typical case - cycles between well and sick
- Chronic (COME) - one case of OM that lasts longer than 3 months
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E in COME
- Chronic Otitis Media Efusion
- efusion - leaking fluid
- like soliders in WWII
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treatment of otitis media 7
- antibiotics / decongestants
- inflation
- myringotomy
- PE tubes
- myringplasty
- T & A
- mastoidectomy
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antibiotics / decongestants
not a real treatment ( not used unless E-tube needs to be unblocked or in extreme cases)
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inflation
- mechanically blowing open the E-tube
- great for adults, but not for children because it will only be temporary
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myringotomy
- to cut the ear drum
- puss under pressure = lance it (cut it)
- it is better to make a nice incision than to let it rupture
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PE tubes 6
- pressure equilization tubes
- not drainage tube
- put in and wait until E tubes mature
- must do a myringotomy first
- ear will force them out in 6 months to a year - normal
- done in doctors office
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myringplasty
- used in chronic comdition
- takes part of own issue and uses it to cover the permanent hole
- must check to make sure that E-tube works first
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T & A
- tonsil actomy
- they can be removed if it is ausing E-tube dysfunction
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mastiodectomy
- only in very serious cases
- take mastoid bone out if it is infected because it can lead to sull and brain infection
- cutting it out leads to a permanent conductive hearing loss
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complications of otitis media
- perforation of the TM - whole in TM
- mastoiditis - infection of mastoid
- glue ear - pulling ot white cement
- cholesteatoma
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