n CME : Your SA Journal of CPD - 'Outrunning' the running ear : main topic

Volume 21, Issue 11
  • ISSN : 0256-2170



Every family physician is well aware of the diagnostic and therapeutic dilemma posed by a child with persistent or recurrent running ears. <br>The most common cause for a running ear in a child is acute purulent OM. <br>By their first birthday, 62.4% of infants have had 1 or more episodes of acute OM and 17.3% 3 or more episodes. <br>Acute OM often follows viral URI. <br>All patients with persistent, recurrent or chronic OM should have a basic medical history taken and an evaluation for under-lying disease. <br>Most children with recurrent acute OM primarily have Eustachian tube dysfunction. If the disease is difficult to control despite maximum medical and/or surgical intervention, evaluation for underlying pathology should be considered. <br>Failing to remove ear wax or debris, using an otoscope that provides inadequate light, or using an inappropriately sized speculum will impair visualisation of the tympanic membrane. It has also been shown that crying and screaming causes the tympanic membrane to become red. <br>The goals of management of the running ear in particularly purulent OM are relief of symptoms, elimination of infection, ventilation of the middle ear and mastoid, avoidance of complications and prevention of further infection. These goals may require medical and/or surgical intervention.

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