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A otite média crónica purulenta simples e suas complicações : a propósito de um caso clínico noutra realidade
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A otite média é uma entidade bastante frequente em todo o mundo, e define-se como um grupo de doenças infeciosas que atingem o ouvido médio, podendo apresentarse em vários subtipos que diferem na apresentação, complicações e tratamento. Esta divide-se em otite média aguda e otite média crónica, sendo a primeira geralmente autolimitada. Pelo contrário, na otite média crónica existe normalmente maior dificuldade no seu diagnóstico e tratamento, estando mais propícia ao desenvolvimento de complicações extracranianas e/ou intracranianas. Aqui, podemos distinguir a otite média crónica purulenta simples, a otite seromucosa e a otite média crónica colesteatomatosa, sendo esta última mais frequente nos dias de hoje. A otite média crónica purulenta simples é uma patologia rara, no entanto ainda se observam muitos casos nos países em desenvolvimento, principalmente quando associados a determinados fatores de risco. Tais como: baixo nível socioeconómico; zonas de sobrepopulação; má alimentação e higiene. O diagnóstico e tratamento precoces desta doença são essenciais, para evitar o desenvolvimento de complicações potencialmente fatais. No presente trabalho é descrito um caso clínico de uma mulher de 50 anos, natural de Cabo Verde, com diagnóstico de otite média crónica purulenta simples complicada com paralisia facial periférica, mastoidite e eventual fístula labiríntica. Por isso, foi submetida a antibioterapia e tratamento cirúrgico (timpanomastoidectomia com rebatimento da parede posterior do canal auditivo externo e timpanoplastia). Este trabalho tem como objetivo mostrar a importância do reconhecimento e valorização de patologias raras na nossa realidade clínica, mas ao mesmo tempo bastante graves. Necessitando de diagnóstico e tratamento imediato.
Otitis media is a very common entity worldwide and is defined as a group of infectious diseases that affect the middle ear and may present in several subtypes that differ in presentation, complications and treatment. It is divided into acute otitis media and chronic otitis media, the first is generally self-limiting. On the other hand, in chronic otitis media there is more difficulty in its diagnosis and treatment, being more propitious to the development of extracranial and/or intracranial complications. Here, we can distinguish chronic suppurative otitis media, otitis media with effusion and otitis media chronic with cholesteatoma, this one is more frequent these days. Chronic suppurative otitis media is a rare condition, however, many cases are still present in developing countries, especially when associated with certain risk factors. Such as: low socioeconomic conditions; overcrowding; poor nutrition and poor hygiene. The early diagnosis and treatment of this disease are essential to avoid the development of potentially life-threatening complications. This paper describes a clinical case of a 50-year-old woman from Cape Verde, diagnosed with chronic suppurative otitis media complicated by facial paralysis, mastoiditis and eventual labyrinthine fistula. Therefore, she underwent antibiotic therapy and surgical treatment (tympanomastoidectomy with bending of the posterior wall of the external auditory canal and tympanoplasty). This work aims to show the importance of the recognition and valuation of rare pathologies in our clinical reality, but at the same time quite serious. Needing diagnosis and immediate treatment.
Otitis media is a very common entity worldwide and is defined as a group of infectious diseases that affect the middle ear and may present in several subtypes that differ in presentation, complications and treatment. It is divided into acute otitis media and chronic otitis media, the first is generally self-limiting. On the other hand, in chronic otitis media there is more difficulty in its diagnosis and treatment, being more propitious to the development of extracranial and/or intracranial complications. Here, we can distinguish chronic suppurative otitis media, otitis media with effusion and otitis media chronic with cholesteatoma, this one is more frequent these days. Chronic suppurative otitis media is a rare condition, however, many cases are still present in developing countries, especially when associated with certain risk factors. Such as: low socioeconomic conditions; overcrowding; poor nutrition and poor hygiene. The early diagnosis and treatment of this disease are essential to avoid the development of potentially life-threatening complications. This paper describes a clinical case of a 50-year-old woman from Cape Verde, diagnosed with chronic suppurative otitis media complicated by facial paralysis, mastoiditis and eventual labyrinthine fistula. Therefore, she underwent antibiotic therapy and surgical treatment (tympanomastoidectomy with bending of the posterior wall of the external auditory canal and tympanoplasty). This work aims to show the importance of the recognition and valuation of rare pathologies in our clinical reality, but at the same time quite serious. Needing diagnosis and immediate treatment.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2019
Palavras-chave
Otite média crónica purulenta simples Países em desenvolvimento Paralisia facial periférica Mastoidite Fístula labiríntica Otorrinolaringologia