Se ha denunciado esta presentación.
Se está descargando tu SlideShare. ×

Chronic Suppurative Otitis Media

Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Anuncio
Próximo SlideShare
ear disorders
ear disorders
Cargando en…3
×

Eche un vistazo a continuación

1 de 24 Anuncio
Anuncio

Más Contenido Relacionado

Presentaciones para usted (20)

Anuncio

Similares a Chronic Suppurative Otitis Media (20)

Anuncio

Chronic Suppurative Otitis Media

  1. 1. Chronic Suppurative Otitis Media Dr. Gangaprasad Waghmare MS
  2. 2. Chronic Suppurative Otitis Media • Chronic inflamation of middle ear causing irreversible changes like perforation • Can cause deafness • Seen mostly in low socio-economic people
  3. 3. Causes • Attack of ME infection • Measels, diptheria, inflenza infection • Disorders of ventilation • Retraction pocket formation • Long standing SOM • Bacteriological
  4. 4. Types • Tubo tympanic • Attico antral
  5. 5. Tubo Tympanic • Involves antero inferior part of me • Sread of infection from septic focci near naso pharynx like Rhinitis Tonsilitis Sinusitis Adenoids From external ear through perforated ear drum Malnutrition & hypogamaglobulinaemia
  6. 6. Clinical featurs • Recurrent otorrhea: watery & mucoid • Deafness: conductive type • Pain: absent • Otoscopy : perforation of tympanic membrane • Infection like :rhinitis, sinusitis,adenoids
  7. 7. Pathological changes • Perforation : central perforation due to necrosis of part having less blood supply • Ossicles : discontinuity of chain due to necrosis • Tympano sclerosis : white chalky deposit on ossicular joint due to hyline degenaration • Polyp : from perforated ear drum
  8. 8. Investigation • Tuning fork test • Audiogram • Radiology: no evidence of erosion
  9. 9. treatment • Septic focci • Aural toilet • Antibiotic ear drops • Systemic antibiotics • Surgical: polyp should surgically removed tympanoplasty
  10. 10. Attico antral or Tympano Mastoid • Postero superior part of ME • Pathalogical changes : formation of cholesteotoma • polyps • granuation • partial or total necrosis
  11. 11. Cholesteotoma • Shining white mass • Contains desquamated epithelium with cheesy odour • It is not a tumor its a skin in wrong place
  12. 12. Formation • Acquired : Increase ME pressure with OM Increase Negative pressure Retraction of pars flacida Pouch neck get closed Sac and skin get localised
  13. 13. • Invasion : growth of epithelium from external auditory canal • Metaplasia: metaplasia of epithelium of middle ear cleft due to suppuration
  14. 14. Bone erodation • By liberation of chemical • Ischaemic necrosis theory • Enzymatic theory: collagenase, acid phoaphate and proteolytic enzyme • Passes from aditus to antrum of mastoid further spread causing many complication • Hence called as dangerous om
  15. 15. Clinical Features • Otorrhoea: scanty & foetid • Deafness: conductive & mild initially • Bleeding : from granulation or polyp
  16. 16. Otoscopic examination • Perforation in pars flacida • Granulation • Cholesteatoma • Cholesterol granuloma [black drum] • Retraction pocket • Symptoms of complication- earache, vertigo, temporal headache, tinnitus, facial palsy, abscess around ear.
  17. 17. Investigation • Audiometry : Moderate to severe conductive deafness • Radiology: mastoid bone sclerosis with bone erosion • Culture & sensitivity of discharge
  18. 18. Treatment • Ostruction of eustachian tube • Aural toilet: a small cholesteoma can be removed by suction • Surgery : granulation polyp should be surgically removed mastoidectomy Tympanoplasty

×