(耳鼻咽喉頭頸外科學(xué))4.2 ASOM

1、( (耳鼻咽喉頭頸外科學(xué)耳鼻咽喉頭頸外科學(xué))4.2 ASOM)4.2 ASOMClinical features Symptoms： General symptoms fever, malaise, anorexia, vomiting, and diarrhea. More evident in child subside after tympanic membrane perforation occursClinical features Symptoms： Local symptoms： Otalgia: sharp before perforation Aural fullness，t

2、innitus, hearing loss Otorrhea: profuse and mucoid discharge initially, mucopurulent latterClinical features Signs： otoscopy： Hyperemic, bulging, poor mobility Perforation, purulent discharge- Palpation: tenderness at mastoid or antrumStage of congestionStage of effusionStage of suppurationconvalesc

3、ence stage Clinical features Audiometry： Usually conductive hearing loss Blood test：WBC Nasopharyngoscopy：DiagnosisHistoryClinical features+Differential diagnosis Acute otitis externa and furuncle： Earache, swelling in canal No or mild inflammation on eardurm Normal hearingDifferential diagnosis Acu

4、te myringitis： Earache No ear discharge Bulla on eardrumTreatment general management： Antibiotics: penicillin, ampicillin, Cefixime etc. 10-14 days； Analgesics antipyretics oral decongestants(antihistamines) Supportive treatmentTreatment general management：Treatment local management： Before perforation： Eardrops: 3% carbolic acid in glycerin myringotomy Indication: 1% ephedrine nose dropsTreatment local management After perforation： aural toilet and eardrops 3% hydrogen peroxide solution0.25% chloromycetin solution0.3% ofloxacin solution3% jiemycin solutionTreatment T