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Treatment

Treatment . Antibiotics Surgery Myringotomy and suction Mastoidectomy (if infection has spread to mastoid region) Tympanoplasty. Complications of otitis media. Cholesteotoma: Sac-like growth due to presence of skin in the middle ear. Dangerous, progressive, highly erosive

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Treatment

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  1. Treatment Antibiotics Surgery Myringotomy and suction Mastoidectomy (if infection has spread to mastoid region) Tympanoplasty

  2. Complications of otitis media Cholesteotoma: Sac-like growth due to presence of skin in the middle ear. Dangerous, progressive, highly erosive Foul-smelling discharge (otorrhea) Treatment: Surgical removal http://www.ent-usa.com/eardrum_and_middle_ear.htm Facial palsy: If erosion of bone occurs, facial nerve may be exposed. Partial/Full paralysis of one side of the face. Treatment: Surgery

  3. Eustachian tube problems Cause: Infections, allergies, blockage due to overgrown adenoids, structural problems. Consequences: Negative middle ear pressure, retracted TM. Audiometric findings: Mild conductive hearing loss, normal static compliance, type C tympanogram.

  4. Methods to open ET Valsalva: Close nostrils and cheek and blow out. Toynbee: Close nostrils and swallow Complications of ET malfunction: Serous effusion Mucous otitis media

  5. Otosclerosis Causes: Hereditary in 70% of cases. Progressive in nature Higher incidence in women, adults. Clinical manifestation: Spongy bone formation over the stapes footplate. Footplate becomes fixed in the oval window.

  6. Other clinical signs Progressive hearing loss Tinnitus Difficulty hearing while chewing Very vascular promontory, rosy glow through TM (Schwartze sign) Paracusis willisii: Speech easier to understand in the presence of background noise.

  7. Audiometric findings Low frequency conductive hearing loss with air-bone gap. As disease progresses, hearing loss spreads to high frequencies. Bone conduction is affected, primarily at 2000 Hz (called Carhart’s notch). Type As tympanogram, absent reflexes

  8. Treatment Earlier: Surgery to free immobilized stapes footplate. Not very successful. Fenestration (new window created in lateral semicircular canal). Effects of fenestration: ~ 25 dB hearing loss to total hearing loss, vertigo, tinnitus, poor word recognition scores, facial paralysis, repeated infections of cavity Stapes mobilization: Middle ear cavity exposed through incision in TM. Effects: Immediate improvement in hearing, however, refixation of stapes often occurred. Most successful treatment: Stapedectomy. Replaced with prosthesis Modification: Stapedotomy

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