In-utero ear development occurs during the same time as ____.
Kidney Development.
An anomaly in one organ system should alert for the possibility in the other.
What are the three physiologic functions of the eustachian tubes?
- Equalization of pressure between the middle ear and the atmosphere.
- Protection of nasopharyngeal sound, pressure and secretions.
- Drainage of secretions from the middle ear to the nasopharynx.
Name the three components needed to Dx AOM
- Recent, abrupt onset of signs/symptoms
- MEE is present (bulging, air/fluid, limited mobility)
- Ear pain or distinct erythema of TM
What criteria must be met for a child to be considered for PET (pressure equalizing tubes)
- Recurrent AOM x 3 in 6 months -or-
2. Recurrent AOM x 4 in one year with at least one episode in the previous 6 months.
Benzocaine drops are contraindicated in what circumstance?
If TM integrity is questioned, then no ear drops should ever be used.
Otitis Externa is often called:
Swimmer’s ear
DDx for AOM include:
OME, Mastoiditis, Dental abscess, Sinusitis, Peritonsillar abscess, Immune Deficiency.
Describe OME:
Evidence of MEE without s/s of acute ear infection. It is generally caused by a disfunction of the eustachian tube.
Signs to differentiate between AOM and OME:
OME: Gradual onset. generally does not have a fever, popping heard by patient, impaired balance.
AOM: Acute onset, has fever, Bulging TM, Errythmematous TM,
The first line treatment of AOM is:
Amox 80-90mg/day divided in two doses
If a child has AOM and has been on Amoxicillin within there previous 30 days, or has conjunctivitis, or has a history of amox not working…then the abx of treatment is
Augmentin (Amox-Clavuanate) 80-90mg/day divided in 2 doses.
This is “Beta-Lactam”
A child with a PCN allergy has just been Dx’d with AOM. The Abx of choice is:
Azithromycin 10mg/kg x 1 day, then 5mg/kg QD x 2-5 days.
Max daily dose is 500/250
