Chronic Otitis Media

Health Care

These are all inflammatory or infectious processes of the middle ear developing on a chronic fashion.

Mucosal chronic otitis media are benign principle, chronic otitis media cholesteatoma are dangerous and require surgical treatment.

Different etiological factors: chronic inflammation or obstruction of the upper airway inflammation maintaining theEustachian tube, local land fragility.

1- Simple chronic ear infections:

MUCOSAL ear infections:

Otitis media with effusion

A- closed eardrum:

→ Children between 3 and 8 years (4%). Rare in adults (nasopharyngeal carcinoma).

→ Diagnostics on the hearing loss in children behind in school.

→ Otoscopy: matt eardrum slightly retracted, amber (yellow-brown).

→ Deafness variable transmission to 4O 2O dB. Tympanogram flat impedance measurement.

→ variable Evolution:

* Spontaneous recovery in the summer,

* Persistent deafness and educational backwardness,

* Retraction pocket and ossicular lysis and cholesteatoma.

→ Treatment:

* Recent stage serous: antibiotics and corticosteroids, paracentesis and suction removal of vegetation;

* Mucous stage tiller deafness .Treatment additional ventilation tubes: Processing of the ground, spa treatments do not prevent frequent recurrences (3O% of cases).

External and internal ear
External and internal ear

B- Otitis open tympanic mucosa:

* Otitis mucosa open tubal otorrhea or eardrum has a generally bilateral otorrhea, mucous or mucopurulent.Tympanic perforation is earlier, or anterior inferior, or total.

* The role of the nasopharynx or land predominates and evolution is often very slow until the age of 8 years or puberty.

* The treatment is medical (removal of the adenoids, vaccine therapy, spa therapy). Never instill ototoxic drops.

* The tympanic perforation sequelae (after acute necrotizing otitis example) can always secondary infection (swimming, push nasopharyngeal).

* Evolution towards possible Tympanosclerosis, ossicular lysis possible, be epidermal passage.

* The treatment is preventative (abstention swimming) or surgical (tympanoplasty).

2- chronic otitis cholesteatomatous:

The keratinized squamous epithelium of the eardrum and the conduit enters the middle ear to the favor of a retraction of the membrane Shrapnell or pars tense, or by direct epidermal migration. Some congenital cholesteatoma of the anterior superior cash exist in young children.

Diagnosis: hearing loss and especially fetid purulent otorrhea sometimes complications.

Otoscopy: marginal perforation (Shrapnell, posterior superior region of the body which is actually the collar of a pocket full of cholesteatoma).

Search a sign of the fistula to the pneumatic test.

TDM to specify the extension.

Surgical excision and combining tympanoplasty; often nécessaire.Surveillance second time control for the very long term as possible recurrence.

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