Common Otologic Problems. Diego A. Preciado MD PhD Children’s National Medical Center George Washington University Washington, DC. Impact of pediatric ear disease. Ear related diagnoses are the most common reason for toddler physician visits in the U.S.
Diego A. Preciado MD PhD
Children’s National Medical Center
George Washington University
Freid, Vital & Health Stats, 1998
Pichichero ME et al., Pediatrics, 2002
MacClements et al., Family Medicine, 2002
Steinbach WJ, Pediatr, 2002.
RIGHT EAR, UPRIGHT
Erythema, edema of EAC, clear secretions
Inc. edema / pain; seropurulent secretions
Intense pain, draining secretions, obstructing debris; lymphadenopathy; cellulitis
Longer than 4 weeks; 4 infections in 1 yearClinical stages of Otitis Externa
Beers & Abramo, Pediatric Emergency Care, 2004
DelBeccaro et al, Drugs, 1999
Oral antibiotics may contribute to emergence of resistance and have therapeutic role only in cases of invasiveness
McCoy SI et al 2004 studied the NHAMCS and found among all US visits for OE (1,716,048):
39% Rx topical Abx
25% Rx oral Abx
No change in treatment trends from 1995-2000AOE
Grubb, MS and Spaugh DC. Clinical Pediatrics, 2010
Mandel et al. Pediatr, 1995
DelBeccaro et al, J Pediatr, 1992
Bluestone CD. Pediatr Infect Dis J, 2001
Mandel EM. Ann OtolRhinolLaryngol, 1994
Equalisation of middle ear pressure?
Aggravation of atrophy?
Ventilation Tube Insertion (VTI)
Spilsbury K, et al. Laryngoscope 2010.