SAQ 231 – Paediatric ENT – acute suppurative otitis media

Question 2. acute suppurative otitis media.

a. Immediate antibiotics

• Indigenous child.
• Immunosuppression.
• Systemic features.
• Tympanic-membrane rupture.
• Follow-up is difficult.
• Age under six months or failure to improve after observation.

b. Complications

• Mastoiditis.
• Intracranial abscess.
• Meningitis.
• Lateral-sinus thrombosis.
• Facial-nerve paralysis.
• Petrous apicitis or Gradenigo syndrome.

c. Perforation management

• Exclude mastoiditis, including CT when clinically indicated.
• Treat with oral antibiotics.
• Arrange ENT review after approximately three months if unhealed.
• Keep the ear dry until healed.
• Avoid ototoxic ear drops such as gentamicin.