Transcript Otitis Media

Otitis Media
OM Case 1

5 y/o Female
 Incomplete cleft of
secondary palate
 Pain in left ear
 Tubes 4 years ago
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No Medications
 Cleft has been
repaired in 2001 and
has healed well.
Otoscopy
Right ear canal clear TM intact
 Amber colored fluid behind left TM
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Tymps
SRT/WR
Audio
Diagnosis

Left otitis media
Case 12 History
9 year old male
 Chronic otitis media
 Eustachian tube dysfunction
 History of PE tube placement
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Tymps
SRT/WR
Audio
Case 3 History
2 year old female
 Pressure Equalization Tubes placed
one month previous for chronic otitis
media.
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SRT/WR
Audio
Case 4 History
3 year old female
 Diagnosed with obstructive sleep apnea
 Has constant nasal drainage and
complains of headaches

Otoscopy
Left tympanic membrane is dull with
possible effusion
 Right tympanic membrane is intact, fluid
bubbles are noted
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Tymps
SRT/WR
Audio
Audio
Recommendation
Myringotomy and tympanostomy tube
placement bilaterally
 Possible adenoidectomy to correct
apnea

Case 5 History
6 year old male
 History of chronic otitis media with
effusion, tube placement approximately
one month prior
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Tymps
SRT/WR
Audio
Case 6 History
23 year old female
 Complains of left ear progressive
hearing loss
 Tympanostomy tubes at age 5 and
perforation repair at age 7.
 Exploratory surgery to rule out
cholesteatoma found only
tympanosclerosis Dec of 2000
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Otoscopy
Left tympanic membrane bulging with
white opacity behind it – no appreciable
landmarks, suspicious for
cholesteatoma
 Right canal obstructed by cerumen
which was removed, canal is narrow
and collapsible and there is evidence of
tympanosclerosis.
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Right and Left
(note: these are just examples)
Tymps
Tymps
WR/SRT
Audio
Audio
CT Scan
Some thickening of the right tympanic
membrane
 On the left – abnormal tissue filled the
external auditory canal associated with
calcification or possible reactive bony
changes – middle ear appears normal
 Left findings are most consistent with
keratosis obturans.

Case 7 History
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58 year-old male
Worker’s compensation injury to right ear
while using a cutting torch (1 month prior)
A hot slay landed in his ear canal
Developed otorrhea and was given drops
Reported that he could taste the drops (it can
be assumed there was a perforation)
All has healed and he feels there has been
an improvement in his hearing.
Otoscopy
Small amount of debris in right ear
which was removed
 Both ear canals are intact and
translucent.
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Tymps
SRT/WR
Audio
Audio
Case 8 History
4 year old male with history of recurrent
acute otitis media and chronic otitis
media with effusion
 Tubes were placed bilaterally
approximately 11 months ago
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Tymps
SRT/WR
Audio
Audio
Case 9 History
4 year old boy
 History of right cholesteatoma
 Underwent right tympanoplasty 7
months prior
 Has has persistent chronic right
suppurative otitis media with foul
smelling discharge
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Otoscopy
Debris was cleaned form the right ear
canal and partially removed cerumen
filling the left canal but was discontinued
due to patient cooperation
 Tympanostomy tube still in place in the
left TM
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Tymps
SRT/WR
Audio
Audio