Post on 10-Jul-2015
transcript
CSOMCHRONIC SUPPURATIVE OTITIS MEDIA
NAUMAN AHMAD
PARTICULARS
• PATIENT NAME – XYZ
• AGE – 27 YEARS
• GENDER – MALE
• ADDRESS – ATTOCK
WITH PATIENT’S PERMISSION
PRESENTING COMPLAINTS
-- DISCHARGE RIGHT EAR
-- DECREASED HEARINGRIGHT EAR
One year
HISTORY OF PRESENT ILLNESS
• One year ago had an episode of upper respiratory tract infection with pain right ear
• Subsequently patient developed intermittent ear discharge
• Discharge:• Profuse• Mucopurulent• Odourless• Not blood stained
• Decreased hearing right ear
PAST HISTORY
OPERATED FOR ACUTE APPENDICITIS 03 YEARS AGO
At C.M.H Lahore
Personal History
Family History
Drug History
Not Contributory
GENERAL PHYSICAL EXAMINATION
-- PULSE 74/ min, regular
-- TEMPERATURE 98*F
-- BLOOD PRESSURE120/80 mm Hg
-- Respiratory Rate 16/ min
-- Pallor - absent
-- Jaundice - negative
- Neck veins - not engorged
- Lymph nodes - not palpable
- Clubbing - Koilonychia- Odema feet
normal
CNS
• NAD
RESPIRATORY SYSTEM
• NAD
GIT
• NAD
CVS
• NAD
SYSTEMIC EXAMINATION
ENT EXAMINATION
EAR
NOSE
THROAT
• EAR
• RIGHT EAR : Medium sized central perforation in the pars tensa
• No discharge
• No cholesteatoma
• LEFT EAR : normal
• Whispered voice not appreciated in right ear
RINNE TEST
• NEGATIVE ON RIGHT SIDE• POSITIVE ON LEFT SIDE
WEBER TEST
. LATERALIZED TO RIGHT SIDE
Tuning fork test
NOSE
•NAD
THROAT
•NAD
PROVISIONAL DIAGNOSIS
CHRONIC SUPPURATIVE OTITIS MEDIA
( TUBOTYMPANIC TYPE , INACTIVE )
INVESTIGATIONS
• PURE TONE AUDIOGRAM
• X-RAY MASTOID
X-RAY MASTOID
FINAL DIAGNOSIS
CHRONIC SUPPURATIVE OTITIS MEDIA(TUBOTYMPNIC)
TREATMENT
• REGULAR AURAL TOILET
• EAR DROPS ( 0.6% ofloxacin 3 drops two times a day for 7 days , steroids -- betamethasone )
• SYSTEMIC ANTIBIOTICS ( Capsule ampicillin 625mg three times a day for 7 days )
• NASAL DECONGESTANTS ( XYLOMETAZOLINE nasal spray three times a day for 7 days )
• Systemic anti-histamines ( tab. loratidine 10mg once daily )
( during active episode )
COUNSELING
• KEEP EAR DRY
• MYRINGOPLASTY