Glomerular Filtration and determinants of glomerular filtration .pptx
Otitis Media With Effusion (OME) Guide: Causes, Symptoms and Treatment
1. BRIG ANWAR UL HAQ
00923018513303
Otitis Media
With
Effusion
2. OME
Chronic accumulation of mucus/non
purulent effusion within the middle ear and
in mastoid air cell system (Middle Ear
Cleft).
Duration >12 weeks
4. Etio-Pathology
Preceded by an episode of AOM with
Otalgia and fever.
Inflammation of eustachian tube
epithelium
Flat cuboidal mucosa
Partially replaced by thickened Pseudo Stratified
Mucus secreting epithelium.
Goblet cells are usually present
Mucus secreting cells are formed.
5. Etio-Pathology
Characteristics of effusion
mixture of the secretions of the
epithelial cells
goblet cells
mucus glands along
inflammatory transudate/exudate
Viscous
Goblet Cells
Mucous glands
10. Etio-Pathology
Allergy
Allergy – Swelling - Infection
GERD
Its common in children
Pepsin is found in the effusion.
Investigations are required to clarify the
role.
11.
12. Etio-Pathology
Prevalance
Age
Bimodal - infancy
- primary school
Peak - one year of age.
Season
Winter>Summer
Respiratory Tract Infections
Ear Infections
13. Etio-Pathology
AOM Episode
Largest single factor
Antibiotics - No effects
Contact with other children
Hereditability
Greater concordance
monozygotic - Higher
Incidence
dizygotic - Lesser Incidence
14. Etio-Pathology
Race
Prevalence is different in different races
Gender
No difference in male or females
Smoking
No effect of parenteral smoking detected.
39. Medical Management-AIMS
Speed up the resolution
Antibiotics
Benefits in first two weeks
long term (>6 weeks) - not recommended
Nasal Decongestants
No Significant effect.
Mucolytics
No Significant result.
40. Medical Management-AIMS
Speed up the resolution
Antibiotics
Benefits in first two weeks
long term (>6 weeks) - not recommended
Nasal Decongestants
No Significant effect.
Mucolytics
No Significant result.
41. Management
Nasal topical Steroids
No difference in resolution.
Systemic Steroids
Not Recommended.
Counseling and hearing tactics.
Disabilities can be minimized by hearing tactics.
Other Approach
Auto Inflation-3.5 times more likely to improve.
Higher efficacy found in older children.
42. Management
Nasal topical Steroids
No difference in resolution.
Systemic Steroids
Not Recommended.
Counseling and hearing tactics.
Disabilities can be minimized by hearing tactics.
Other Approach
Auto Inflation-3.5 times more likely to improve.
Higher efficacy found in older children.
43. Management
Nasal topical Steroids
No difference in resolution.
Systemic Steroids
Not Recommended.
Counseling and hearing tactics.
Disabilities can be minimized by hearing tactics.
Other Approach
Auto Inflation-3.5 times more likely to improve.
Higher efficacy found in older children.
44.
45.
46.
47.
48.
49. Management
Surgical Management.
Ventilation Tubes Insertion.
Posterosuperior insertion is not recommended –damages the Ossicular Chain
No difference in radial or circumferential inscion or anterosuperior and
anteroinferior position.
To maximize the duration-insertion in anteroinferior is recommended .
Made with Teflon,Silicone,Titanium,Gold.
Aspirate as much of the middle ear fluid as possible through the myringotomy
before inserting VT, there is no evidence that is required.
Topical preparations are used to prevent tube block with blood or infection.
Myringotomy with aspiration.
Not shown to be effective.
55. Complications
Displacement of tube to middle ear
Perforation of TM.
Scarring and weakening of the TM.
Early extrusion or blockage.
Cholesteatoma formation.