Otorhinolaryngology · MU Plovdiv

2. Anatomy and physiology of the middle ear. Methods of examination. Acute Otitis media in adults and infants. Otitis media with effusion, Mastoiditis, Facial nerve paralysis. Clinical complications.

Inside: 54 sections · 39 labelled pictures · 3 tables · 72 flashcards · 46 min

Topic 2 of 18 in the MU Plovdiv syllabus for Otorhinolaryngology (Medicine, Year 4). The free AceMed note covers it in 39 sections, about 6,721 words (46 min of reading), with 72 flashcards.

In this note

  1. Anatomy and physiology of the middle ear. Methods of examination. Acute Otitis media in adults and infants. Otitis media with effusion, Mastoiditis, Facial nerve paralysis. Clinical complications.
  2. 1) The middle ear consists of 3 parts
  3. The tympanic Cavity
  4. Auditory ossicles
  5. Eustachian tube
  6. Examination methods
  7. Otitis media
  8. 1) Acute otitis media
  9. Adults
  10. 4) Recurrent acute otitis media 4 in 1 yr / 3 in 6mo
  11. 5) Otitis media with effusion (OME) ~ Glue ear
  12. 7) Mastoiditis
  13. 8) Facial nerve paralysis » Intratemporal Complication
  14. Summary
  15. Facial nerve paralysis Intratemporal Complication
  16. Facial nerve paralysis
  17. Clinical anatomy of the external and middle ear.
  18. Clinical anatomy of the external ear
  19. Clinical anatomy of the middle ear (tympanic cavity)
  20. Acute Inflammation of the Middle Ear (Acute Otitis Media)
  21. Classification
  22. Clinical Picture
  23. Paraclinical and Radiological Examinations
  24. Treatment Options
  25. Possible Complications
  26. Differential Diagnosis
  27. Eustachian tube dysfunction and serous otitis with effusion.
  28. Paraclinical & radiological examinations
  29. Treatment options
  30. Possible complications
  31. Differential diagnosis
  32. SEROUS OTITIS MEDIA (OTITIS MEDIA WITH EFFUSION – OME)
  33. Classification of OME
  34. Clinical picture
  35. Paraclinical & Radiological examinations
  36. Complications
  37. Mastoiditis
  38. Etiopathogenesis
  39. Peripheral Paralysis of the Facial Nerve

1) The middle ear consists of 3 parts

  1. The tympanic cavity – (bounded laterally by the tympanic membrane)
  2. The system of temporal bone air cells Auditory ossicles
  3. The eustachian tube

1. The tympanic Membrane - ear drum

Consists of two portions – Pars tensa and pars flaccida

1.1. Pars tensa

  • Much larger part
  • Funnel-shaped area stretched between the malleus handle and the bony ear canal
  • The fibrocartilaginous ring is at the circumference of the tympanic membrane and it anchors the tympanic membrane in the tympanic sulcus of the tympanic bone
  • Composed of 3 layers:
  1. a) outer cutaneous layer → smooth, stratified squamous epithelium which reflects light
  2. b) inner mucosal layer → borders tympanic cavity & consists of a single layer of squamous epithelium
  3. c) Lamina propria → is a fibrous layer between inner and outer layer & made of two layers of connective tissue fibers
  1. radiate layer (radially directed fibres)
  2. circular layer (circular fibres)

1.2. Pars Flaccida

  • Also referred to as the Shrapnell membrane
  • Smaller than pars tensa
  • Located superior to the malleolar folds
  • Has no middle fibrous layer

Important surface markings of the tympanic membrane

  1. Short process of malleus
  2. Handle of the malleus (Manubrium)
  3. Umbo
  4. Cone of light (light reflex)

N: B: the handle of malleus and the light reflex form an angle that is open anteriorly

4 Quadrants of the tympanic membrane

formed by 2 imaginary lines along the handle of malleus vertically and at the level of the umbo horizontally

  1. Posterosuperior
  2. Posteroinferior
  3. Anterosuperior
  4. Anteroinferior

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