广州医学院：《头颈外科学》课程PPT教学课件（讲稿）Bacteriology

OTITIS MEDIA Guangzhou medical college Second Affiliated Hospital Otolaryngology Ouyang shunlin

OTITIS MEDIA Guangzhou medical college Second Affiliated Hospital Otolaryngology Ouyang shunlin

The most important disease of the middle ear and mastoid are inflammations of various kinds and hearing loses. Tumors of the middle ear are rare. In this chapter we'l mainly discussed acute suppurative otitis media (ASOM)and chronic suppurative otitis media(CSOM)

 The most important disease of the middle ear and mastoid are inflammations of various kinds and hearing loses. Tumors of the middle ear are rare . In this chapter we'll mainly discussed acute suppurative otitis media (ASOM) and chronic suppurative otitis media (CSOM)

ASOM a Acute suppurative otitis media is one of the most common infections of childhood t may accompany any upper respiratory tract infection such as the common cold. measles scarlet fever, or influenza. When virulent bacteria invade the middle ear, an acute suppuration occurs

ASOM  Acute suppurative otitis media is one of the most common infections of childhood. It may accompany any upper respiratory tract infection such as the common cold, measles, scarlet fever, or influenza. When virulent bacteria invade the middle ear, an acute suppuration occurs

Bacteriology The haemolytic streptococcus, staphylococcus or the pneumococcus are most commonly responsible for the infection

Bacteriology  The haemolytic streptococcus, staphylococcus or the pneumococcus are most commonly responsible for the infection

Infection route (bActeria or virus via the pharyngotympanic tube into middle ear is the maximum incidence in childhood (2Infection via the external meatus is liable to occur when a tympanic membrance perforation is present otitis media arising as a blood-borne infection is rare

Infection route  ①Bacteria or virus via the pharyngotympanic tube into middle ear is the maximum incidence in childhood.  ②Infection via the external meatus is liable to occur when a tympanic membrance perforation is present.  ③otitis media arising as a blood-borne infection is rare

Pathology 1.tubal occlusion 2. presuppuration 3. suppuration; a 4 resolution

Pathology  1.tubal occlusion;  2.presuppuration;  3.suppuration;  4.resolution

symptoms severe, deep throbbing pain in the ear is the cardinal symptoms temperature elevation(more in infants or children a hearing loss, dizziness, nausea, tinnitus Purulence(a mixture of blood and pus)

 severe, deep throbbing pain in the ear is the cardinal symptoms;  temperature elevation (more in infants or children)  hearing loss, dizziness, nausea, tinnitus  Purulence (a mixture of blood and pus) symptoms

Sians examination shows the tympanic membrance is thick red, and dull. If rupture has occurred, pus and the perforation may be seen conductive hearing loss there is usually pain during pressure over the mastoid antrum

Signs  examination shows the tympanic membrance is thick, red, and dull. If rupture has occurred, pus and the perforation may be seen.  conductive hearing loss.  there is usually pain during pressure over the mastoid antrum

Differential Diagnosis external otitis or furunculosis of external auditory meatus postauricular tenderness bullous myringitis: the earache may be intense but deafness only slight, the membrane may be obscured by a large haemorrhagic bleb or blebs

Differential Diagnosis  external otitis or furunculosis of external auditory meatus: postauricular tenderness.  bullous myringitis: the earache may be intense but deafness only slight, the membrane may be obscured by a large haemorrhagic bleb or blebs

Treatment 1. Antibiotics should be given in full dosage Penicillin is the drug of choice for empirical selection, except when the patient is sensitive to this drug. In any case, antibiotic sensitivity studies are important When sensitivity to penicillin is known to exist erythromycin, or broad-spectrum antibiotics may be used

Treatment  1.Antibiotics should be given in full dosage. Penicillin is the drug of choice for empirical selection, except when the patient is sensitive to this drug. In any case, antibiotic sensitivity studies are important. When sensitivity to penicillin is known to exist, erythromycin, or broad-spectrum antibiotics may be used