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Otorhinolaryngology Hospital,The First Affiliated Hospital of Sun Yat-sen University  Hongyan  Jiang  MD&PhD Ear Diseases
EAR  DISEASES: Diseases of the External Ear Otitis Media and Middle Ear Effusions  Chronic Otitis Media  Otosclerosis  Meniere’s Disease  Deafness
Diseases of the External Ear The external ear is composed of the auricle, the external auditory canal (EAC), and the epithelial surface of the tympanic membrane Trauma,  infections  ,neoplasms
TRAUMA TO THE EXTERNAL EAR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TRAUMA TO THE EXTERNAL EAR AURICULAR HEMATOMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TRAUMA TO THE EXTERNAL EAR This loss of tissue is from a bite   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
INFECTION AND INFLAMMATION OF THE EXTERNAL EAR AURICLE Cellulitis of the Auricle: Cellulitis is a bacterial infection that usually follows abrasion, laceration Allergic Dermatitis of the Auricle: Allergic dermatitis of the auricle is haracterized by localized erythema, swelling, and itching in the area of allergen exposure. EXTERNAL AUDITORY CANAL Acute Localized Otitis Externa (Furuncle) Acute Diffuse Otitis Externa (Swimmer’s Ear) Chronic Otitis Externa Necrotizing (Malignant) External Otitis Fungal Otitis Externa (Otomycosis)
INFECTION AND INFLAMMATION OF THE EXTERNAL EAR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Otitis Media and Otitis Media with Effusions Synonyms Used in the Past for Otitis Media Acute Otitis Media  Otitis Media with Effusion Suppurative  Serous Purulent  Secretory Bacterial  Mucoid Glue ear Middle ear effusion DEFINITIONS: Otitis media represents an inflammatory condition of the middle ear space, without reference to cause or pathogenesis. Middle ear effusion is the liquid resulting from OM.An effusion may be either serous (thin, watery), mucoid (viscid, thick), or purulent (pus). The process may be  acute (0 to 3 weeks in duration ),  subacute(3 to 12 weeks in duration) , or  chronic (greater than 12 weeks in duration ).
Acute otitis media and mastoiditis
Definition  ,[object Object],Acute suppurative otitis media  Acute non-suppurative otitis media
Bacteriology  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Routine of infection   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Why a higher incidence of acute otitis media occurs in children?
Routine of infection ,[object Object],[object Object],[object Object],[object Object]
Pathology  ,[object Object],[object Object],[object Object]
Symptoms  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physical examination ,[object Object],[object Object],[object Object],Physical examination usually reveals a thickened, erythematous or bulging tympanic membrane with limited or no mobility to pneumatic otoscopy .
Physical examination ,[object Object],[object Object],[object Object],[object Object],[object Object]
Physical examination ,[object Object],[object Object]
Physical findings Erythema bulging tympanic membrane otorrhea perforation
Lab tests ,[object Object],[object Object]
Hearing tests ,[object Object],[object Object],[object Object],[object Object]
Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Managements  ,[object Object],[object Object],[object Object],[object Object],[object Object],Daily Dosage for Common Antibiotic Agents in Acute Otitis Media
Managements ,[object Object],[object Object],[object Object],[object Object],[object Object]
Managements ,[object Object],[object Object],[object Object],[object Object],[object Object]
Managements  ,[object Object],[object Object],[object Object],[object Object]
Follow-up ,[object Object],[object Object],[object Object],[object Object],[object Object]
Acute mastoiditis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Acute mastoiditis ,[object Object],[object Object],[object Object],[object Object]
Acute mastoiditis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Acute mastoiditis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Acute mastoiditis ,[object Object],[object Object]
Acute mastoiditis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Otitis media with effusion
Background ,[object Object],[object Object]
Definition of OME ,[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object]
Pathogenesis(Etiology) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathogenesis (Etiology) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification of Otitis media ,[object Object],[object Object]
Symptoms  of OME ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physical examination ,[object Object],[object Object],[object Object],[object Object],[object Object]
Physical examination ,[object Object],[object Object],[object Object],[object Object]
Physical examination ,[object Object],[object Object]
Diagnosis  ,[object Object],[object Object],[object Object],--Lateral nasopharyngeal radiograph:  hypertroph of adenoid --Nasopharyngeal exam: to exclude  space-occupation lesion
 
 
Differentiated diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Differentiated diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Differentiated diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Middle Ear Atelectasis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Middle Ear Atelectasis Patient is at risk for  cholesteatoma  due to skin accumulation within  retraction pockets
Diagnosis of otitis media ,[object Object]
Managements  ,[object Object],[object Object],[object Object],[object Object]
Managements ,[object Object],[object Object],[object Object],[object Object]
Managements ,[object Object],[object Object],[object Object],[object Object],[object Object]
Management of AOM alternative medical treatment   ,[object Object],[object Object],[object Object],[object Object]
Medical Treatment of OME ,[object Object],[object Object],[object Object],[object Object],[object Object]
Surgical treatment for otitis media ,[object Object],[object Object],[object Object],[object Object],[object Object],----Tympanostomy tubes placement.
Tympanostomy Tubes (aim) ,[object Object],[object Object],[object Object]
Surgical treatment for otitis media   ----Adenoidectomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],Surgical treatment for otitis media   ---- Laser-assisted myringotomy
[object Object],[object Object],Surgical treatment for otitis media   ---- Laser-assisted myringotomy
Thanks for your attention!
The ET has three functions   (1)  ventilation  of the middle ear associated with equalization of air pressure in the middle ear with atmospheric pressure. (2)  protection  of the middle ear from sound and secretions. (3)  drainage of middle ear secretions  into the nasopharynx with the assistance of the mucociliary system of the ET and middle ear mucous membrane. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Ear Diseases Hospital Guide: Otorhinolaryngology, Otitis Media, Effusions, Mastoiditis

  • 1. Otorhinolaryngology Hospital,The First Affiliated Hospital of Sun Yat-sen University Hongyan Jiang MD&PhD Ear Diseases
  • 2. EAR DISEASES: Diseases of the External Ear Otitis Media and Middle Ear Effusions Chronic Otitis Media Otosclerosis Meniere’s Disease Deafness
  • 3. Diseases of the External Ear The external ear is composed of the auricle, the external auditory canal (EAC), and the epithelial surface of the tympanic membrane Trauma, infections ,neoplasms
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  • 7. INFECTION AND INFLAMMATION OF THE EXTERNAL EAR AURICLE Cellulitis of the Auricle: Cellulitis is a bacterial infection that usually follows abrasion, laceration Allergic Dermatitis of the Auricle: Allergic dermatitis of the auricle is haracterized by localized erythema, swelling, and itching in the area of allergen exposure. EXTERNAL AUDITORY CANAL Acute Localized Otitis Externa (Furuncle) Acute Diffuse Otitis Externa (Swimmer’s Ear) Chronic Otitis Externa Necrotizing (Malignant) External Otitis Fungal Otitis Externa (Otomycosis)
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  • 9. Otitis Media and Otitis Media with Effusions Synonyms Used in the Past for Otitis Media Acute Otitis Media Otitis Media with Effusion Suppurative Serous Purulent Secretory Bacterial Mucoid Glue ear Middle ear effusion DEFINITIONS: Otitis media represents an inflammatory condition of the middle ear space, without reference to cause or pathogenesis. Middle ear effusion is the liquid resulting from OM.An effusion may be either serous (thin, watery), mucoid (viscid, thick), or purulent (pus). The process may be acute (0 to 3 weeks in duration ), subacute(3 to 12 weeks in duration) , or chronic (greater than 12 weeks in duration ).
  • 10. Acute otitis media and mastoiditis
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  • 20. Physical findings Erythema bulging tympanic membrane otorrhea perforation
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  • 35. Otitis media with effusion
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  • 54. Middle Ear Atelectasis Patient is at risk for cholesteatoma due to skin accumulation within retraction pockets
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  • 66. Thanks for your attention!
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Notas do Editor

  1. Trauma to the external ear is common in all age groups. The unprotected auricle is at risk for all kinds of trauma including cold or hot thermal injury and blunt or sharp injury resulting in ecchymosis, hematoma, laceration, or fracture.
  2. Unfortunately, numerous terms have been used to describe the various inflammatory conditions of the middle ear space (Table). This has resulted in both confusion and a lack of uniformity in reporting.An attempt to standardize nomenclature was undertaken in the early 1980s and will be used throughout this chapter when discussing this disease process   This chapter deals primarily with two disease processes: acute otitis media (AOM) and chronic otitis media with effusion (COME).
  3. Eustachian tube (ET) dysfunction is considered the major etiologic factor in the development of middle ear disease. Why a higher incidence of acute otitis media occurs in children?
  4. These usually include otalgia, fever, irritability, anorexia, vomiting, diarrhea, or otorrhea  
  5. Physical examination usually reveals a thickened, erythematous or bulging tympanic membrane with limited or no mobility to pneumatic otoscopy. Erythema:It caused by dilatation and congestion of the capillaries
  6. Oral decongestants may relieve nasal congestion, providing some aeration of the ET. Their efficacy has not been proven, however.
  7. The tympanic membrane may present numerous physical findings including thickening, opacification, and impaired mobility. An air-fluid level and/or bubbles may be observed through a translucent tympanic membrane. This entity is distinguished from AOM in that the signs and symptoms of acute infection are lacking (eg, otalgia, fever, otorrhea).