急性化膿性中耳炎ASO

ACUTESUPPURATIVEOTITISMEDIA

(ASOM)第一頁(yè)，共十六頁(yè)。Acutesuppurativeotitismediaresultsfrombacterialinfectionofthemiddleearcleft,oftenasabacterialcomplicationofthecommoncold.Thisismorefrequentinchildrenthaninadults.

第二頁(yè)，共十六頁(yè)。Etiology

#Thecommoninfectiveorganismsarebetahemolyticstreptococcus,pneumo-coccus,Hemophilusinfluenzae,andstaphylococcus.

#Eustachiantubes:viralupperrespiratoryinfection,enlargedadenoids,sinusinfections,allergy-causingedemaintheeustachiantuberegion,andcleftpalate.

第三頁(yè)，共十六頁(yè)。#Othercause:traumaticrupture,perforationofthetympanicmembrane,frominfectionfollowingearsurgery.

#ASOMisaself-limitingdisease,andwhentreatedadequatelyitrarelyleavesanyresidualchange.

第四頁(yè)，共十六頁(yè)。ClinicalFeatures

Symptoms.

Fever,malaise

Otalgia

Decreasein

hearing

Dischargefromtheearcanal:muco-purulentorpurulent.(perforationofthetympanicmembrane).第五頁(yè)，共十六頁(yè)。OnExamination

Intheearlystage,thetympanicmembranewillshowretractionandlackofmobility.

Nextwiththeonsetofedemaandexudationthedrumwillloseitslandmarks,appearthickanddull,andmayhaveafluidlevel.

Thefluidisthickandnotclear,asinthecaseofserousotitismedia.

第六頁(yè)，共十六頁(yè)。Tympanicmembraneoutwardandcausebulgingofthedrum.

Ifuntreatedthetympanicmembranewillrupture,givingrisetoaserosanguinousandthenmucopurulentorpurulentdischargefromtheear.

Perforationoccursintympanicmembranecentral.第七頁(yè)，共十六頁(yè)。TympanicmembranebeforeperforationwithASOM第八頁(yè)，共十六頁(yè)。TympanicmembraneafterperforationwithASOM第九頁(yè)，共十六頁(yè)。Afterperforation,painandfevermaynotbeasmarkedasintheearlierstages,butthereispersistenceofpurulentdischargeandrecurrenceofpain.

Pressureonthemastoidtipwillproducepain-mastoidtenderness.

Infectionmayspreadtomastoidcausemastoiditis.第十頁(yè)，共十六頁(yè)。Tuningforktests:aconductivehearingloss.

X-rayfilmorCTscanexaminationsintheearlystagesmayshowhazinessorcloudiness.

第十一頁(yè)，共十六頁(yè)。Treatment

SymptomaticTreatment.

Analgesics:pain

antipyretics:fever.

fluidreplacement:preventofdehydration

第十二頁(yè)，共十六頁(yè)。Thecultureandthesensitivityofdischarge

Antibiotictreatment:Penicillingivensystemicallywillmanagemostoftheseinfections.InchildrenthepossibilityofHemophilusinfluenzaeshouldbekeptinmind,andthismayrequireampicillinifthereisnoresponsetopenicillinorifthecultureandthesensitivitytestsoindicate.Antibioticsshouldbegivenfor5to7days,certainlynotless.第十三頁(yè)，共十六頁(yè)。Systemicdecongestantshelpreduceswellingandtherebyfacilitatedrainageofthemiddleear.Thesearegivenforaperiodoftwoweeksormore,dependingonhowquicklythemiddleearbecomesfreeoffluid.

Ifthedrumappearsfullandbulging,amyringotomyshouldbecarriedoutfordrainage.第十四頁(yè)，共十六頁(yè)。

EardropsalsocanbevalueforinfectioninASOM.0.25%-1%Chloramphenicoland0.3%Ofloxacineardropsarerecommended.

Beforeusingeardrops,

cleaningpurulentdischarge

inearby2%

hydrogehperoxidesolution.

Coldcreamcanbeused

toprotectskinmacerated

fromeardischarge.

Localtreatment第十五頁(yè)，共十六頁(yè)。內(nèi)容梗概ACUTESUPPURATIVEOTITISMEDIA

(ASOM)。Tymp