Transcript Diapositiva 1 - UEMS ORL SECTION

For the Candidate
Case Report:
A mother comes with her 14 months daughter to the ENT-Specialist. The
baby presents with left retro-auricular redness and fever (39.2 C) of 24 hours
duration. She has had an upper airway respiratory infection one week ago.
There was no ear drainage, however, she has had purulent nasal drainage.
Otoscopic Picture
Question 1:
a) What do you see on the pictures?
b) What is your first diagnosis?
c) Do you have further questions?
d) What is your next step?
Patients Foto of the
retroauricular region
For the Examiner
Blue Print:
Diagnosis, Bacteria, possible complications and treatment of acute otitis media with early
mastoiditis.
By Ari Sismanis (Athens)
a. Most common complication is mastoiditis, which may progress to
Subperiosteal abscess
1. Bezold abscess—abscess in digastric groove of SCM
b. Petrous apicitis
1, Gradenigo syndrome--otorrhea, retro-orbital pain, and lateral rectus palsy
secondary to irritation of CN VI within Dorello canal
c. Facial Nerve paralysis:
perform myringotomy, culture, and administer antibiotics
Residual middle ear effusion after treatment
a. 70% of patients at 2 weeks
b. 20% after 2 months
c. 10% after 3 months
d. 90% of middle ear effusions persistent after an episode of treated AOM
resolve within 90 days
Question 1: 20%
a) What do you see on the pictures?
b) What is your first diagnosis?
c) Do you have further questions?
d) What is your next step?
Diagnosis: Acute otitis media with
early mastoiditis
Question 2:
Are further diagnostic procedures necessary?
Further Diagnostic
procedures necessary?
Plain-X-ray? CT of the
temporal bones ?
Question 3: Which complications of acute otitis media do you
know?
50% ??
Question 4:
What Therapy would you consider?
Question 5: 30%
What are the main causative organisms of AOM?
It was immediately
done: in this case it
showed cloudiness of
the left mastoid
without any
destruction of the air
cells
Acute otitis media (AOM)
Causative organisms
Streptococcus pneumoniae (40%)
Haemophilus influenzae (30%)
Moraxella catarrhalis (20%)
WE HOPE TO SEE YOU IN VIENNA!!