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Presentations of Middle Ear Disease PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "PRESENTATIONS OF MIDDLE EAR DISEASE" by Elizabeth Rose.

This medical PowerPoint presentation is about middle ear diseases. The middle ear is the space behind the eardrum that contains the three tiny bones that transmit sound vibrations to the inner ear. Middle ear diseases are common and can affect people of all ages. Some of the most common middle ear diseases include:

Otitis Media: Otitis media is an infection of the middle ear that causes inflammation and fluid buildup. It can be acute or chronic and is most common in children.
Eustachian Tube Dysfunction: The Eustachian tube connects the middle ear to the back of the throat. When it is not functioning correctly, it can lead to a buildup of pressure in the middle ear and cause pain, hearing loss, and other symptoms.
Cholesteatoma: Cholesteatoma is an abnormal growth of skin cells in the middle ear that can lead to hearing loss, vertigo, and other complications.
Otosclerosis: Otosclerosis is a condition that causes the bones in the middle ear to grow abnormally, leading to hearing loss.
Tympanic Membrane Perforation: Tympanic membrane perforation is a tear or hole in the eardrum that can be caused by infection, trauma, or other factors. It can cause hearing loss and other complications.

Treatment for middle ear diseases can vary depending on the specific condition and its severity. In some cases, medications such as antibiotics or corticosteroids may be prescribed, while in other cases, surgery may be necessary to repair or remove damaged tissue. It is essential to seek medical attention if you suspect that you have a middle ear disease to prevent further complications.

Tags : middle ear diseases, Otitis Media, Eustachian Tube Dysfunction, Cholesteatoma, Otosclerosis, Tympanic Membrane Perforation

Published on : Jun 23, 2023 | Views : 30983 | Downloads : 5

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Slide 1-

PRESENTATIONS OF MIDDLE EAR DISEASE Elizabeth Rose Royal Victorian Eye and Ear Hospital Royal Children’s Hospital Dorland’s Medical Dictionary
Slide 2-

A “look and learn” lecture Middle-ear conditions Management of otitis media Differential diagnosis of ear pain Clinical cases
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Normal TM http://me.hawkelibrary.com/new/main.php?g2_itemId=315
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Translucent (can see through it) Handle of the malleus Incus Stapedius tendon Round window niche Normal TM http://me.hawkelibrary.com/new/main.php?g2_itemId=315
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OTITIS MEDIAA SPECTRUM OF DISEASE acute otitis media chronic otitis media with effusion atelectasis of the tympanic membrane chronic adhesive otitis media chronic suppurative otitis media tubotympanic (“safe”) atticoantral (“unsafe”) and may be a continuum of disease
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Acute otitis media Otitis media with effusion Normal Usual sequence after AOM http://me.hawkelibrary.com/new/main.php?g2_itemId=187 http://me.hawkelibrary.com/new/main.php?g2_itemId=315 (all accessed 12-03-13) http://me.hawkelibrary.com/new/main.php?g2_itemId=524
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Acute otitis media Perforation with discharge (otorrhoea) Normal (perforation heals) Persistent perforation But AOM may also lead to a perforation of the TM http://me.hawkelibrary.com/new/main.php?g2_itemId=369 http://me.hawkelibrary.com/new/main.php?g2_itemId=524 http://otitismedia.hawkelibrary.com/aom/3_2_CSOM_Otorrhea http://otitismedia.hawkelibrary.com/normal/tm_2
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Acute otitis media Otitis media with effusion Cholesteatoma Atelectasis and adhesions with continuing Eustachian tube dysfunction … and more severe problems http://hawkelibrary.com http://me.hawkelibrary.com/new/main.php?g2_itemId=524 http://me.hawkelibrary.com/new/main.php?g2_itemId=187 http://me.hawkelibrary.com/new/main.php?g2_itemId=1225 http://me.hawkelibrary.com/new/main.php?g2_itemId=1486
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http://www.dr-li.net/Hearing%20Health.html
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Diagnosis of acute otitis media (Therapeutic Guidelines) A history of acute onset of symptoms and signs otalgia, ear pulling, otorrhoea, fever, anorexia, vomiting AND 2. Middle ear effusion (otorrhoea if a TP perforation) AND 3. signs and symptoms of middle ear inflammation, characterised by redness of the tympanic membrane.
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Management of AOM Pain relief Decongestants (oral/topical) and antihistamines do not make the eustachian tube function better Not recommended
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Management of AOM Who should be treated with antibiotics?
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Antibiotic therapy if severe symptoms pain/fever perforation bilateral disease possible suppurative complication mastoiditis Meningitis or other intracranial complication ≤ 2 years old Indigenous (ATSI , Maori and Pacific Islanders) immune deficiency cochlear implant only hearing ear
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Antibiotic therapy Recommended treatment is: amoxicillin 45mg/kg/day in 3 doses Can give up to 100mg/kg/day Continue for 10 days If no improvement in 2 days change to amoxicillin/clavulanate
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If an allergy to penicillin cefuroxime child 3 months to 2 years: 10 mg/kg up to 125 mg; 2 years or more: 15 mg/kg up to 500 mg orally, 12-hourly for 5 days
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Antibiotic therapy older children who can be accurate about their symptoms should be treated symptomatically if no improvement after 2 days consider treatment with antibiotics
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CHRONIC OTITIS MEDIA WITH EFFUSION(COME) the presence of a middle ear effusion asymptomatic apart from some hearing loss
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CHRONIC OTITIS MEDIA WITH EFFUSION Normal OME
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AOM COME http://me.hawkelibrary.com/new/main.php?g2_itemId=524
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AOM COME TM bulging Cannot see lateral process of the malleus Opaque White from the pus in the ME Inflammation/prominent vessels TM is retracted Malleus handle is more prominent Opaque Yellow from effusion https://sydneyentclinic.com/sean-flanagan/patient-resources-2/patient-resources/hearing-loss/glue-ear-middle-ear-infections-and-grommets/ https://www.drrahmatorlummc.com/serousotitismedia.htm
Slide 21-

MIDDLE-EAR EFFUSION https://www.emaze.com/@AOOROWLL https://www.drrahmatorlummc.com/serousotitismedia.htm Middle ear full of fluid Air-fluid level
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CHRONIC ADHESIVE OTITIS MEDIA TM is thin and adheres to the ossicles, often with erosion https://www.medical.theclinics.com/article/S0025-7125(18)30068-3/fulltext
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TYMPANIC MEMBRANE PERFORATIONS https://journals.sagepub.com/doi/abs/10.1093/innovait/inp007?journalCode=inoa https://dontforgetthebubbles.com/otitis-media/ Likely to have hearing impairment Hearing may be normal
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CHRONIC SUPPURATIVE OTITIS MEDIA(CSOM)“deafness and discharge” persistent disease insidious onset severe destruction irreversible sequelae
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1. tubotympanic disease (“safe”) central perforation 2. atticoantral disease (“unsafe”) cholesteatoma the presence of keratinising squamous epithelium in the middle ear
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TUBOTYMPANIC(central perforation) https://dontforgetthebubbles.com/otitis-media/ Central perforation with active discharge (otorrhoea)
Slide 27-

ATTICOANTRAL DISEASECHOLESTEATOMA(marginal or attic perforation) https://www.southlakeent.com/services-procedures/ears-hearing/ear-concerns/cholesteatomas Erosion in the attic with keratin Can see cholesteatoma in the mesotympanum as well Likely to surround the ossicles (incus)
Slide 28-

Cholesteatoma A non-neoplastic accumulation of keratinising stratified squamous epithelium in the tympanic cavity (middle ear) or mastoid air cells Resorbs (damages) underlying bone Potentially dangerous to the patient
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CHOLESTEATOMAComplications Hearing loss Intracranial .tympanic membrane .ossicles .inner ear Vertigo Tinnitus Facial paralysis https://www.vectorstock.com/royalty-free-vector/ear-anatomy-vector-23904762
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MANAGEMENT OF CHRONICOTITIS MEDIA WITH EFFUSION(and also retraction/atelectasis of the tympanic membrane)
Slide 31-

What are grommets?
Slide 32-

https://jaydeeautocables.com.au/products/rubber-grommet-assortment-kit Any tube with flanges https://twen.rs-online.com/web/p/rubber-grommets/1879453/ https://venuspack.com.au/product-category/poly-bags-netting/tarpaulins/
Slide 33-

?Young surfers https://kialoa.com/blogs/talkstory/endearing-photos-of-young-surfers https://diannewolfer.com/books/picture-books/granny-grommet-and-me/
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Wallace and gromit https://www.radiotimes.com/movies/is-wallace-and-gromit-on-netflix/
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MIDDLE EARVENTILATION TUBES https://slideplayer.com/slide/14431309/
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AKA grommets tubes pressure equalisation tubes middle ear ventilation tubes tympanostomy tubes NOT a drainage tube (it’s role in life is to ventilate!)
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https://www.slideshare.net/bethfernandezaud/unit-3-review-30629514 Mucoid middle ear effusion
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Ventilates the middle ear https://www.healthinfo.org.nz/index.htm?Ventilation-tubes-grommets.htm
Slide 39-

COME Who should have middle ear ventilation tubes? (for OME)
Slide 40-

Natural history of OME after AOM
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1. COME for 4 months at least, with hearing loss 2. COME in a child ‘at risk’ regardless of the hearing 3. COME and structural damage to the tympanic membrane
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1. Hearing loss median hearing loss is mild but there is a wide range no data on the criteria for what is a significant hearing loss
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O ] O O O O O X X X X X [ [ [ [ [ ] ] ] ] X 50% of children with persistent OME have hearing thresholds at 20 dB
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O ] O O O O O X X X X X [ [ [ [ [ ] ] ] ] X 20% of children with persistent OME have hearing thresholds at >35 dB
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2. An ‘at risk’ child has an increased risk of developmental difficulties due to factors not related to the OME: physical sensory, e.g. blindness cognitive, e.g. developmental delay behavioural
Slide 46-

https://www.pinterest.com.au/pin/350999364682083551/
Slide 47-

3. Structural damage to the tympanic membrane https://app1.unmc.edu/medicine/heywood/otology/unit4-middle-ear-disease-diagnosis.cfm Retraction of the tympanic membrane can get worse and damage the ossicles or become a cholesteatoma
Slide 48-

Children with persistent OME who: Do not have other risk factors Do not have significant hearing loss Do not have damage to the tympanic membrane or middle ear Can be evaluated every three months
Slide 49-

Take it to Telehealth - 1remember referred otalgia If the ear is normal seek the cause of the pain
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Take it to Telehealth – 2More is missed in medicine by not looking than by not knowing https://www.thesun.co.uk/living/2712715/can-you-spot-the-dog-on-the-rug-hilarious-photos-show-animals-blend-into-the-background-when-it-suits-them/