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1、Acute suppurative otitis media,Overview,Middle ear mucosa in acute suppurative inflammation.Common for ENT.PathogensStreptococcus pneumoniae肺炎链球菌 Haemophilus influenzae流感嗜血杆菌 Hemolytic Streptococcus溶血性链球菌 Staphylococcus葡萄球菌,Etiology,Acute upper respiratory tract infectionAcute rhinitisAcute nasophar
2、yngitisAcute tonsillitisAcute infectious diseasesScarlet feverMeaslesWhooping cough,Etiology,Infection by Eustachian tube Infants due to eustachian tube short and flat Infection by the external auditory canal Infection by blood,Symptoms,Systemic symptoms:Chills,feverLoss of appetiteRelieve after tym
3、panic membrane perforationEaracheHearing loss and tinnitusOtorrhea,conductive deafness,Treatment,Systemic treatmentAntibiotics to control infectionDecongestantsSupportive therapy,Treatment,Topical treatment,Phenol glycerol Ear DropsMyringotomy,Before perforation of tympanic membrane,Cleaning pus wit
4、h 3%hydrogen peroxideAntibiotic eardropsRemove nasal,pharyngeal diseasesadenoidal hypertrophychronic sinusitistonsillitis,After perforation of tympanic membrane,Treatment,Acute mastoiditis,Etiology,Complication of acute suppurative otitis mediaPathogens:drug resistant or Insensitive to commonly used
5、 antibioticsSimultaneously with other diseases:scarlet fever,measles,etcPoor drainage anatomical structure of mastoid air cell,Symptom,Earache continuously exists after the perforation of tympanic membrane,or with serious headacheEar discharging increase insteadNo hearing improve after the perforati
6、on of tympanic membrane or more serious hearing lossSystemic symptom become more seriousDifferential diagnosis:Furuncle external auditory canal,Chronic suppurative otitis media,Pathogenesis,After acute suppurative otitis mediaAcute necrotizing otitis media Simultaneously with other diseases:scarlet
7、fever;measles,etcEustachian tube dysfunction Chronic nasal and pharyngeal diseasesPathogens Staphylococcus aureus 金黄色葡萄球菌Pseudomonas aeruginosa 肺炎链球菌,Categories,chronic simple otitis media chronic otitis media with osteitis chronic otitis media with cholesteatoma,chronic simple otitis media,chronic
8、otitis media with osteitis,Cholesteatoma,Symptoms,Ear discharging IntermittentlyMucus secretionsMild conductive deafness Perforation of tympanic membrane,Middle ear mucosa smooth or mild congestive,Ossicular mostly intactX-ray or CTNo bone destructionpneumatic type or diploetic type mastoid process,
9、Large perforation in tense part of tympanic membrane or Marginal perforation,there are granulation or polyps in tympanumX-ray or CT Mostly diploetic type mastoid process Soft tissue shadow in tympanum,tympanic antrum entrance and mastoid process,Symptoms,Symptoms,Ear discharging continuously Produce
10、 foul-smelling pus which is characteristic of anaerobic streptococciMild or serious conductive deafness,Mixed hearing loss Occasionally in advanced stage,Treatment,Remove upper respiratory diseases chronic sinusitistonsillitisTopical treatmentmedicine/surgery according to different types,Clear pus i
11、n external auditory canal and tympanum completely before ear dropsAminoglycoside otic solution forbiddenAvoid powder Avoid colored ear drops Corrodent forbidden,Antibiotics ear drops,Treatment,Pus unobstructed drainage same as the simple but regular follow-up Poor drainage/suspected complications ma
12、stoid operation,Treatment,Surgery as soon as possible1873 Simple mastoidectomy1878 Myringoplasty1891 Radical mastoidectomy 1910 Modified radical Mastoidectomy,Treatment,Now tympanoplasty with or without mastoidectomy,Classification Extra-cranial complications Intra-cranial complications,Complication
13、s,Chronic otitis media with cholesteatoma,Acute mastoiditis and mastoid abscesses(most common complication).Petrositis.Labyrinthitis.Facial paralysis.Osteomyelitis of the temporal bone,Extra-cranial complications,Extra-cranial complications,External otitisCervical lymphadenitisRetropharyngeal absces
14、sesParapharyngeal abscesses,Intracranial complications,Extradural abscess(commonest intracranial complication)Subdural abscessMeningitisBrain abscessTemporal lobe abscessCerebellar abscessLateral sinus thrombosisOtitic hydrocephalus,Extra-cranial complications,Mastoid abscess,Extra-cranial complications,Labyrinthitis,Extra-cranial complications,Facial palsy,Extra-cranial complications,Intracranial complications,Brain Abscess,Intracranial complications,hydrocephalus,Intracranial complications,Thanks！,
