Wednesday, April 25, 2012

Untreated sinus symptom may cause otitis media

The word “otitis” means ear inflammation. “Media” means middle. Otitis media is thus middle ear’s infection and / or inflammation owing to blocked Eustachian tube. Generally, H. influenzae, M. catarrhalis and S. pneumoniae cause otitis media. The disease could be acute, chronic and otitis media with effusion.




Acute otitis media (AOM)

AOM means acute inflammation or infection of the middle ear.  The tympanic membrane (TM) may bulge in the patients suffering from AOM. Other symptoms include middle ear effusion (MEE) that may contain pathogens. Both virus and bacteria can cause AOM. Major pathogens causing AOM are Streptococcus pyogenes, M. catarrhalis, H. influenzae and S. penumoniae.
Otorrhea, air-fluid level, decrease in mobility of the TM and bulging of TM indicates MEE. Otorrhea means muco-purulent secretion from the ear. Otalgia (earache) and apparent redness of TM is ascribed to the inflammation of TM. Bacteria and viruses trigger earache in the patients.  Sore throat, restlessness in night and fever may also be associated with AOM.
Otitis media with effusion (OME)
OME, also called secretory otitis media, refers to minor inflammation of the middle ear. MEE is non-purulent and generally free of pathogens. OME can be secondary to AOM, but it may develop as an independent condition. Nasopharyngities, sinusitis and allergy can cause edema of the mucosa. As a result, the Eustachian tube may get blocked, causing OME. Chronic sinus symptom or allergic rhinitis-induced edema may trigger chronic secretory otitis media. In case of recurrent chronic and acute OME, radiographic images of the paranasal sinuses will help in confirming / ruling out an association between OME and sinusitis.
AOM vs. OME
Fluid in the middle ear and hearing loss are associated with both OME and AOM. Irritability, fever and earache are present in AOM but absent in OME. Pus coming from the ear, “runny ear”, may occur in some AOM cases. However, OME patients do not have runny ear.
Chronic otitis media (COM)
COM could be active, inactive and inactive with frequent reactivation of primary condition. Otorrhea is a common symptom of chronic active otitis media. The chronic inactive otitis media may lead to retraction pocket, perforation and ossicular resorption.
Otitis media and sinusitis are related to each other. Exposure to secondary smoke and time spent in day-care may cause both sinus symptom(s) and otitis media. Inflammation means presence of fluid in the middle ear without any infection. Infection means bacteria- or virus-induced inflammation. That is why otitis media needs an antibiotic therapy.

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