Otitis Media

Features

Chronic Ear Discharge >14 Days.

• Recurrent mucoid or mucopurulent discharge onset with cold/moisture in ear.
• Non foul smelling, copious in amount.
• Tympanic membrane perforation with conductive hearing loss.
• Often amenable to surgical correction.

Management

• The medical treatment of chronic otitis media includes regular removal of infected debris, use of earplugs to protect against water exposure.
• Topical antibiotic drops (ofloxacin 0.3% or ciprofloxacin with dexamethasone) for exacerbations.

Cipotic-D/ Quniodex (topical ciprofloxacin dexamethasone) ear drops 2 drops thrice daily for 5 days

• Oral ciprofloxacin, active against Pseudomonas, 500 mg twice a day for 1-6 weeks, may help dry a chronically dischargUng ear.
• Tab- Ciproxin (ciprofloxacin) 500mg PO x BD for 1-6 weeks 'OR' Tab- Renova (Gemifloxacin) 320 mg PO x OD for 2-3 weeks.
• Tab- Brufen I Inflamatax (Ibuprofen I Flurbiprofen) 400 mg PO x SOS (for pain)
• Tab- Lorin-NSA or Softin (Loratidine) 10mg PO x OD at night for a week if there is itching or other allergic symptoms.
• If not responding: Refer to ENT surgeon.
• Definitive management is surgical in most cases. Successful reconstruction of the tympanic membrane may be achieved in about 90% of cases, often with elimination of infection and significant improvement in hearing.
• When the mastoid air cells are involved by irreversible infection, they should be exenterated at the same time through a mastoidectomy.