急性化脓性中耳炎专题知识培训课件.ppt

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,2,Acute 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 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 sanitation, 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. Pathogenic 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 inflammation suppurative stage catarrhal stage infection resolves rupture of tympanic infection resolves chronicity,Pathology,invade,causing,急性化脓性中耳炎专题知识,7,organisms mucous me,Sources of infection in otitis mediathe Eustachian tube is the chief routea. upper respiratory tract infection frequently a complication 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,8,Sources of infection in otitis,c. swimming and diving d. anatomical factors the Eustachian tube is shorter , wider and more horizontal in child 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 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, e,Local 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,急性化脓性中耳炎专题知识,11,Local 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 conductiv,Examinationon otoscopic 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,13,Examinationon otoscopic exami,tenderness of bone usually in the bone behind the earhearing test conductive deafnessblood examination a high leucocyte count,Examination,急性化脓性中耳炎专题知识,14,tenderness 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 i,General managementantibiotics 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,16,General 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 perforation 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,17,Local management treatment,Treatment 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,18,Treatment of causative factor,not treated in time or inefficiently treated, go on to chronicity. Perforated, somewhat difficulty the cause is not removed, a tendency recur.,prognosis,急性化脓性中耳炎专题知识,19,not treated in time or,Thanks For Your Attention !,急性化脓性中耳炎专题知识,20,Thanks For Your Attention !急性化,