Middle Ear

2. Middle Ear • The middle ear is compossed of tympanum or middle ear cavity, antrum and mastoid cells, and the eustachian tube

4. Definition • Chronic otitis media describe a variety of signs, symptoms, and physical findings that result from the long-term damage to the middle ear by infection and inflammation

5. Pathophysiology • usually caused by eustachian tube dysfunction • may also result from a perforation in the eardrum that failed to heal after trauma or an acute infection of the middle ear • can also result in a benign growth of cholesteatoma

6. Pathophysiology It includes: • Severe retraction or perforation of the eardrum • Scarring or erosion of the small, sound conducting bones of the middle ear • Chronic or recurring drainage from the ear • Inflammation causing erosion of the bony cover or the facial nerve, balance canals, or cochlea (hearing organ) • Erosion of the bony borders of the middle ear or mastoid, resulting in infection spreading to the meninges (the coverings of the brain) or brain • Presence of cholesteatoma • Persistence of fluid behind an intact eardrum

7. Clinical Presentations • Persistent blockage of fullness of the ear • Hearing loss • Chronic ear drainage, which may have a very foul smell • Development of balance problems • Facial weakness/ Facial paralysis • Persistent deep ear pain or headache • Fever • confusion or sleepiness • Drainage or swelling behind the ear

8. Clinical presentations • Some people with chronic otitis media develop a cholesteatoma in the middle ear. • A cholesteatoma, which destroys bone, greatly increases the likelihood of other serious complications • In severe conditions, brain infections may develop

9. Signs and symptoms • painless discharge of pus, which may have a very foul smell, from the ear • inflammation of the inner ear • facial paralysis