Reasonable Rascal
12-09-01, 18:18
Otitis Media
TERMINOLOGY
Otitis Media (OM) - inflammation of the middle ear
Acute Otitis Media (AOM) - Rapid and short onset of signs and symptoms, normally limited to 3 weeks duration
Otitis Media with Effusion (OME) - Middle ear inflammation with a collection of fluid in the middle ear space
Subacute Otitis Media with Effusion- Effusion of the middle ear lasting from 3 weeks to 3 months
Chronic Otitis Media with Effusion - Middle ear effusion that lasts longer than 3 months
Otoscope - An instrument designed for illumination and examination of the (outside) inner ear including the ear canal and the ear drum. Normally consists of a handle containing a battery or 120VAC powered light, magnifying lens and cone shaped speculum.
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Otitis Media constitutes one of the most prevalent childhood diseases in the early years. Many are the parents who have sat up all night with a child with an acute earache who is unable to sleep because of the pain. By 3 years of age approximately 70% of all children will have had one episode and 1/3 will have had 3 of more episodes. Incidences are highest in children age 6 months to 2 years.
Incidences gradually decrease with age save for a modest increase in the 5-6 year age group. It is less prevalent once the child is over 7 years of age. It is more prevalent in boys than girls at less than school age, but later the numbers even out with equal chances for both sexes. Previous studies have concluded that the presence of tobacco users in the house increases occurrences, but no mention is made of socio-economic, genetic or other factors and thus the studies are at least modestly suspect.
AOM is most frequently caused by Streptococcus pneumoniae and Haemophilus influenzae. The non-infectious type is unknown as to cause, though frequently it is the result of blockages in the eustachian tubes caused by edema accompanying Upper Respiratory Infection (URI), allergies or enlarged adenoids, also referred to as hypertrophic. Chronic cases of OM are usually an extension of an acute case that has not been properly treated.
OM is normally the result of a dysfunctioning eustachian tube. The tube is part of the "contiguous" system which is comprised of the nose, sinuses, eustachian tube, middle ear, the mastoid atrum and air cells.
There are several complications possible as a result of OM. The most prevalent is hearing loss from prolonged inflammation, though usually mild in severity. It can however impair language skill development and speech. Structural complications affecting the tympanic membrane (eardrum) or bones are less common but may be serious in nature. The area of the mastoid atrum (jaw hinge) is conducive to infection settling in the porous air cells, which can spread from there. In rare cases actual surgical intervention to literally scrape the infectious cells out may be required. Development of such infections are normally the result of long term chronic infections rather than acute.
Diagnosis
In cases of AOM diagnosis is normally made by using an otoscope to visualize the eardrum. The eardrum appears intact, bright red and bulging. The usual landmarks of the bony prominence are obscured by the bulging membrane.
In OME the findings may be a slightly injected, dull-gray membrane, obscured landmarks and a visible fluid level behind the eardrum if air is present above the level of the fluid.
Reference: Whaley and Wong's Nursing Care of Infants and Children, 5th Edition
TERMINOLOGY
Otitis Media (OM) - inflammation of the middle ear
Acute Otitis Media (AOM) - Rapid and short onset of signs and symptoms, normally limited to 3 weeks duration
Otitis Media with Effusion (OME) - Middle ear inflammation with a collection of fluid in the middle ear space
Subacute Otitis Media with Effusion- Effusion of the middle ear lasting from 3 weeks to 3 months
Chronic Otitis Media with Effusion - Middle ear effusion that lasts longer than 3 months
Otoscope - An instrument designed for illumination and examination of the (outside) inner ear including the ear canal and the ear drum. Normally consists of a handle containing a battery or 120VAC powered light, magnifying lens and cone shaped speculum.
---------------------------------------------
Otitis Media constitutes one of the most prevalent childhood diseases in the early years. Many are the parents who have sat up all night with a child with an acute earache who is unable to sleep because of the pain. By 3 years of age approximately 70% of all children will have had one episode and 1/3 will have had 3 of more episodes. Incidences are highest in children age 6 months to 2 years.
Incidences gradually decrease with age save for a modest increase in the 5-6 year age group. It is less prevalent once the child is over 7 years of age. It is more prevalent in boys than girls at less than school age, but later the numbers even out with equal chances for both sexes. Previous studies have concluded that the presence of tobacco users in the house increases occurrences, but no mention is made of socio-economic, genetic or other factors and thus the studies are at least modestly suspect.
AOM is most frequently caused by Streptococcus pneumoniae and Haemophilus influenzae. The non-infectious type is unknown as to cause, though frequently it is the result of blockages in the eustachian tubes caused by edema accompanying Upper Respiratory Infection (URI), allergies or enlarged adenoids, also referred to as hypertrophic. Chronic cases of OM are usually an extension of an acute case that has not been properly treated.
OM is normally the result of a dysfunctioning eustachian tube. The tube is part of the "contiguous" system which is comprised of the nose, sinuses, eustachian tube, middle ear, the mastoid atrum and air cells.
There are several complications possible as a result of OM. The most prevalent is hearing loss from prolonged inflammation, though usually mild in severity. It can however impair language skill development and speech. Structural complications affecting the tympanic membrane (eardrum) or bones are less common but may be serious in nature. The area of the mastoid atrum (jaw hinge) is conducive to infection settling in the porous air cells, which can spread from there. In rare cases actual surgical intervention to literally scrape the infectious cells out may be required. Development of such infections are normally the result of long term chronic infections rather than acute.
Diagnosis
In cases of AOM diagnosis is normally made by using an otoscope to visualize the eardrum. The eardrum appears intact, bright red and bulging. The usual landmarks of the bony prominence are obscured by the bulging membrane.
In OME the findings may be a slightly injected, dull-gray membrane, obscured landmarks and a visible fluid level behind the eardrum if air is present above the level of the fluid.
Reference: Whaley and Wong's Nursing Care of Infants and Children, 5th Edition