Acute Suppurative Otitis Media

First School of Clinical Sciences Dept. of Otorhinolaryngology

Definition :

Introduction

Acute Suppurative Otitis Media is middle ear mucosal acute

suppurative inflammation .

Its pathological changes in tympanic cavity, children is most

common The invasion usually come from upper respiratory
infection.
pathogenic bacteria

cause by

pneumococcus

Hemophilus influenza
beta streptococcus staphylococci

Route of infection

1. Route of eustachian tube

most common
acute upper respiratory infection, acute infectious disease
swimming or diving in uncleanness water incorrect eustachian
tube inflation treatment of nasal cavity
incorrect position for infant feeding

2. route of acoustic duct, tympanic membrane

injury of tympanic membrane puncture for tympanic membrane insert
pipe for tympanic membrane
3. Route of hematogenous infection: extremely scarce

Pathology
blood plasma and other formed elements effusion

(mucosa of tympanic cavity thickening)

cilia ablate ;

middle ear mucosa hyperemia

Goblet cell increased

Inflammatory exudate in tympanic

cavity change purulence
Eardrum Compression, anaemia
Correct treatment
1.inflammation extinction
2.Mucosa of tympanic cavity
Recovery normal
Inflammation extinction

repaired naturally

perforation be

surgical repair

thrombophlebitis
Incorrect treatment
perforation of ear drum
liquor puris effluent

Chronic Suppurative Otitis Media

Clinical manifestation
1.general symptoms patient have chilly fever lassitude bad
appetite the symptoms are more heavy for children some patients have
vomitting and diarrhea.
The general symptoms relieve obviously as soon as perforation appear in
ear drum
2. local symptoms
1 earache:deep pain Throbbing pain and pricking pain radiating
pain with homolateral head or tooth
children often cry deep in the night pain relieve obviously as soon as
perforation of ear drum.
2 hearing defect tinnitus vertigo deafness palliate after
perforation of ear drum
3 otorrhea The fluid like blood at first and then change to
mucopurulent discharge fluid.

3. Examinations
Otoscopy Congestion in tympanic flaccid part the
congestion is diffuse also can see distend perforation in
eardrum
Aural region palpation Mastoid tenderness
Hearing examination air conduction hearing loss
Hemogram White blood(cell)count WBC
polymorphonuclear leucocytes increase hemogram
recovery normal gradually after perforation in eardrum

Eardrum image of acute purulent otitis media before perforation

Congestion in tympanic flaccid part the

congestion is diffuse also can see
distend perforation in eardrum

Eardrum image of acute purulent otitis media after perforation

Treatment
Treatment principles: control infection , drainage smooth and removal etiological

factors
1 general treatments
1 Antibiotics The treatment request early as soon as possible and full
dosage
Penicillins and cephalosporins are the commonly used antibiotics .
The sensitive antibiotics should be used after perforation of ear drum according to
bacterial culture and susceptibility test.
2 1 Ephedrin could be used in nasal cavity
3 Maintenance therapy supply Glucose and so on

2 Local treatment
1 2 phenol glycerite could be used in acoustic duct and eardrum
before perforation of ear drum.
Myringotomy when tympanic cavity has a lot of purulent secretion.
2 3 hydrogen peroxide 0.5% terivid could be used in acoustic
duct and eardrum after perforation of ear drum.
Tympanic membrane repairing could be used after perforation of ear drum
3 Etilogical treatment
The diseases must be active treatment in nose pharyngeal portion
such as adenoid hypertrophy chronic sinusitis chronic tonsillitis and so
on .

Thanks!