Applied Pathophysiology: Otitis Media Chapter 12

Applied Pathophysiology: A Conceptual Approach to the Mechanisms of Disease

• Covers Chapter 12: Altered Somatic and Special Sensory Function
• Module 4: Clinical Models.

Otitis Media

• A common childhood condition: 75% of children have at least one episode by age 3.
• Acute Otitis Media (AOM): Infection in the middle ear.
• Fluid (effusion) in the middle ear: Creates an optimal environment for pathogen growth
• Often associated with upper respiratory infections

Otitis Media Pathophysiology

• Pathophysiology: Details the progression of events leading to otitis media.
• Normal vs Infected Middle Ear: Describes the basic structures and how infection alters these structures.
• Effusion: Fluid accumulation in the middle ear.
• Optimal environment for pathogens: Effusion in the middle ear creates ideal conditions for microorganisms to thrive.
• Eustachian tube dysfunction: Obstruction of the eustachian tube contributes to fluid buildup.

Otitis Media Clinical Manifestations

• General symptoms: Acute pain, enlarged periauricular lymph nodes, runny nose (rhinorrhea), fever
• Impaired hearing
• Perforated tympanic membrane: Hole in the eardrum.
• Otoscopic examination: Visual inspection of the ear drum, may reveal gray, red, or bulging membrane; possible fluid presence
• Scarring: Possible scarring from previous perforations.
• AOM: Acute onset, middle ear effusion, inflammation, recurrent episodes (≥ 3 episodes in 6 months or ≥ 4 over a year).
• OME: (Otitis Media with Effusion), more frequent than AOM, fluid in the middle ear, no inflammation, may be recurrent.

Otitis Media Diagnostic Criteria

• History of acute onset: Patient's history of when symptoms began.
• Otoscopic examination confirmation: Using an otoscope to examine the ear drum for physical evidence of infection;
• Effusion: Presence of fluid in the middle ear
• Bulging or absent mobility of the tympanic membrane: Abnormal movement of the eardrum.
• Visible air-fluid level: Air pockets within the fluid.
• Ear canal discharge (otorrhea): Pus or fluid draining from the ear canal

Otitis Media Treatment

• Diagnosis driven: Based on accurate diagnosis.
• AOM v OME: AOM often requires antibiotics, as OME does not benefit from antibiotics.
• Antibiotic resistance: Increasing rate of antibiotic resistance.
• Uncomplicated AOM: Observation is usually sufficient, but antibiotics might be needed for individuals not responding to observation alone.
• Amoxicillin (first line): Generally the preferred choice for antibiotics (AOM).
• Alternative antibiotics: Considered if amoxicillin is ineffective.

Explore the mechanisms of altered somatic and special sensory functions relevant to otitis media, a common childhood condition. This quiz covers the pathophysiology, the impact of infections, and the role of the Eustachian tube in fluid accumulation. Test your understanding of this significant clinical model.