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