急性化脓性中耳炎专题知识培训课件

1、急性化脓性中耳炎专题知识急性化脓性中耳炎专题知识Acute suppurative Otitis Media First Affiliated Hospital of Chongqing Medical University Yu Lin急性化脓性中耳炎专题知识2Acute suppurative Otitis Media Acute suppurative otitis media (ASOM) is inflammation of the middle ear cleft due to bacterial infection. It is also referred to as acute

2、 otitis media .Acute suppurative otitis media急性化脓性中耳炎专题知识3 Acute suppurative otiti ASOM is most common in children between the ages of 3 to 7 years. Such infants have a short, wide, more horizonally placed eustachian tube than adults, allowing contamination from the regurgitation of feed. Poor sanit

3、ation, over-crowding and malnutrition are all risk factors in children. Risk factors in all age groups include recurrent or chronic rhinosinusitis, chest disease and eustachian tube dysfunction .急性化脓性中耳炎专题知识4 ASOM is most common i ASOM is a bacterial disease caused by pus forming organisms. Pathogen

4、ic bacteria have been isolated from the nasopharynx in up to 97% of children with ASOM. The bacterial infection may be a primary infection, or secondary following a viral acute non-suppurative otitis media. Bacteriology急性化脓性中耳炎专题知识5 Bacteriology急性化脓性中耳炎专题知识5急性化脓性中耳炎专题知识培训课件organisms mucous membrane

5、inflammation suppurative stage catarrhal stage infection resolves rupture of tympanic infection resolves chronicity Pathology invadecausing急性化脓性中耳炎专题知识7organisms mucous meSources of infection in otitis mediathe Eustachian tube is the chief routea. upper respiratory tract infection frequently a compl

6、ication of viral infection common cold, acute rhinitis ,acute tonsillitis acute adenoiditis b. acute infection measles, scarlet fever or influenza急性化脓性中耳炎专题知识8Sources of infection in otitis c. swimming and diving d. anatomical factors the Eustachian tube is shorter , wider and more horizontal in chi

7、ld the external auditory meatus traumatic perforation of tympanic membrane急性化脓性中耳炎专题知识9 c. swimming and diving急性化脓性中 General symptoms fever, elevation of pulse rate, malaise Children suffer from general toxaemia and local symptoms are not evident. Temperature may be as high as 39,the child is crying

8、 and pulling at the ear or burrowing it into the pillow.Symptom and sign急性化脓性中耳炎专题知识10 General symptoms fever, eLocal symptoms otalgia sharp, lancinating character due to accumulation of pus and pressure necrosis of the tympanic membrane . If tympanic membrane ruptures, the pain goes away. symptom急性

9、化脓性中耳炎专题知识11Local symptoms symptom急性化 hearing loss conductive type , tinnitusa conductive hearing loss which progresses otorrhea occurs after episodes of pain, and is due to perforation of the tympanic membrane and release of pus . symptom急性化脓性中耳炎专题知识12 hearing loss conductivExaminationon otoscopic

10、examinationthe earliest stage, the injection of thevessles around malleus. The drum changes to bright red , bulges, all the landmark vanished.at last, perforation.急性化脓性中耳炎专题知识13Examinationon otoscopic examitenderness of bone usually in the bone behind the earhearing test conductive deafnessblood exa

11、mination a high leucocyte countExamination急性化脓性中耳炎专题知识14tenderness of bone usuall Acute otitis media is usually diagnosed via visualization of the tympanic membrane in combination with the appropriate clinical history. diagnose otoscope急性化脓性中耳炎专题知识15 Acute otitis media iGeneral managementantibiotics

12、 haemolytic streptococcus sensitive to penicillin full doses ,a full 10-day course treatment急性化脓性中耳炎专题知识16General managementtreatment急性Local management a. before perforation eardrops 3% carbolic acid in glycerin myringotomy indication : persistence of pain or fever more 24 to 48 hours b. after perfo

13、ration aural toilet and eardrops 3% hydrogen peroxide solution 0.25% chloromycetin solution 0.3% ofloxacin solution 3% lincomycin solution treatment急性化脓性中耳炎专题知识17Local management treatmentTreatment of causative factor indication after myringotomy, not recover Predisposing conditions to ASOM should be treated after resolution. adenoidectomy tonsillectomy rhinitis sinusitis treatment急性化脓性中耳炎专题知识18Treatment of causative factor not treated in time or inefficiently treated,