J. S.

AYURVEDA MAHAVIDYALAYA
DEPARTMENT OF SHALAKYATANTRA

ASOM : ACCUTE SUPPURATIVE OTITIS

MEDIA
A E T I O LO GY
S TA G E S OF ASOM :
Viral infection of upper respiratory
tract and than pyogenic organisms STAGE &
SIGN SYMPTOM PATHOLOGY
NAME
invade the middle ear.

ROUTE OF INFECTION : -Oedema &

hyperaemia of N.P.
• Eustachian tube : most common end of eustachian
tube blocks the
• External ear : traumatic perforations of 1st
• TM retracted
Mild deafness
E.T.
• Prominence of -Absorption of air
tm Tubal
lateral process
• Ear fullness &
& -ve intratympanic
occlusion earache
of malleus pressure
• Blood borne : uncommon route • No fever
P R E D I S P O S I N G FA C T O R : • Loss of cone of
light
-Retraction of TM
-Some degree of
effusion in middle
• Recurrent attack of common cold, ear

URTI, measles, diphtheria, whooping

cough
• Infection of tonsils and adenoids -Tubal occlucion
prolonged
• Chronic rhinitis - sinusitis • Beginning-
• Marked
-Pyogenic
earache-
Congestion of organisms invade
• Nasal allergy pars tensa
throbbing
tympanic cavity
nature
• Tumours of nasopharynx 2nd (cart wheel
• Deafness &
-Hyperaemia of
Pre- app) & loss of lining of tympanic
Tinnitus-
• Cleft palate suppuration COL
mainly in
cavity
• Later-whole -Inflammatoty
adults
• Packing of nose or nasopharynx for TM gets
• High degree
exudate in middle
congested ear
epistaxix • TFT-
fever &
-TM becomes
restlessness
MOST COMMON conductive H.L.
in child
congested

ORGANISM :
• Streptococcus pneumoniae
• Haemophilus influenzae • TM
Red,bulging,los
• Moraxella catarrhalis s of landmark • Earache-
-Formation of pus
• Yellow spot for excruciating
in middle ear and
T R E AT M E N T : 3rd
pus outcome
• Tenderness
• Deafness
may
some extent to
mastoid air cells
may be elicted increased
Suppuration -TM starts bulging
at mastoid child-fever
to the point of
(A) MEDICAL TREATMENT : antrum 102 to 103 F,
rupture
• X-Rays • vomiting,diar
1.Antibacterial therapy (Amoxicilin, mastoid- rhoea,convul
clouding of air sion
Ampicilin) cell due to
2.Decongestant nasal drops exudate

(Ephedrine)
• Blood
3.Oral nasal decongestant tinged/mucopu -Membrane rupture
rulent to release pus
(Pseudophedrine) 4 th
discharge in • Earache -Subsidence of
4.Analgesics & antipyretics Resolution EAC,pulsatile decrease at symptoms
• Perforation in release of -Inflammatory
(Paracetamol) TM pus process to resolve
• Hyperaemia
5.Ear toilet begins to
(B) SURGICAL TREATMENT
6.Dry local heat : subsides

1.Tympanocentesis - needle aspiration of fluid from middle ear. • In virulence of organism is high or poor resistance of
patient.
2.Myringotomy - An incision is put in the TM to evacuate middle • Disease spread beyond middle ear space
ear fluid. 5 Complication
th
• Leads to,
Acute mastoiditis, Subperiosteal abscess, Meningitis,
3.Mastoidectomy - Diagnosis of osteitis on CT warrants Brain abscess, Labyrinthis, Extradural abscess, Facial
paralysis 2024-25 Batch
mastoidectomy to remove the necrotic and infected bone.
4.I&D of Subperiosteal postauricular abscess 4 th Year
5.Tympanoplasty - In cases of permanent tympanic perforation  2013 Bhavna
and ossicular necrosis Chaudhary