Otitis Media

Question 1

What is OM?

Answer 1

Inflammation of the middle ear

Question 2

At what age is OM most common?

Answer 2

3-6 years

Question 3

What would you see on examination?

Answer 3

Inflamed tympanic membrane

Loss of light reflex

Buging

Question 4

Main complaint

Answer 4

earache

Question 5

Signs in children

Answer 5

Holding, tugging, rubbing the ear

Non-specific symptoms (fever, crying, poor feeding etc)

Question 6

4 main symptoms

Answer 6

Earache
Fever
Deafness
Irritability

Question 7

Mx if systemically well

What would you say?

Answer 7

Regular paracetamol or ibuprofen

Usual course is 3 days, but may last <1 week

Question 8

Indications for giving abx (5)

Answer 8

Systemically unwell
Perforation
Complications
V young (<2 years)
Bilateral infection

Question 9

What abx would you give if indicated?

How long for?

Answer 9

5-7 day course of amoxicillin (or clarithromycin in pen allergy)

Question 10

Complications of OM

2

Answer 10

Mastoiditis

Tympanic membrane perforation

Question 11

What is mastoiditis?

Answer 11

Infection of the air cells in the mastoid bone (behind the ear)

Question 12

Mx of mastoiditis

Answer 12

EMERGENCY!!
Admit
IV abx + myringotmoy to relieve pressure

Question 13

What can perforation lead to?

How long does it take to heal?

Answer 13

Hearing loss

Usually takes a few weeks to resolve