الفهرس 
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Abstract
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The present study was performed on 70 neonates (30
intensive care unite neonates and 20 full term neonates & 20
outpatient neonates to establish the normal microotoscopic
appearance of newborn tympanic membrane and to determine
prospectively the prevelance and bacteriology of NEE in ICU
neonates in comparisone with controle group of full term
neonates.
The normal appearance of the newborn T.M. differes
greatly from that of younge children. Most significant are
collapsed and distensible external auditory skin and
horizantal orientation of tympanic membrane.
As regared prevelance of NEE in bot ICU and fullterm
neonates, a high incidence of NEE has been reported among
ICU neonates (30%) than among full term neonates (10%).
There was no statistical singificant for sex and age of
neonates in relation to MEE affection.
As regard percentage of NEE in relation to risk,
wefound that (33.3%) of premature babies showed NEE and
(50%) of babies with pneumonia showed MEE. If pneumonia was
complicated by septicaemia, NEE occured in (66.7%) of these
cases. In case of Jaundice. we had NEE in 20% of cases.
According to unilateral and bilateral NEE in relation to
risk, we found that premature babies and those with
septicaemia and Jaundice had 100% bilateral NEE and neonates
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suffering pneumenia showed 66.7% of cases with bilateral MEE
and 33.3% of cases with unilateral MEE.
As regard bacteriology of suppurative MEE in leu
neonates, we found high incidence of B-striptacocci in
(50%), gram negative enteric organisms in (33.3%) and
staphylococcal species in (16.7%).
Aslo, fullterm neonates with suppurative MEE, we found
B-streptococci in (40%), gram negative enteric organisms in
(25%), H. influenza in (25%) and staphylococcal species in
( 10%)•
In conclusion, MEE is more common in the neonatal leu
than previously suspected especially in those newborns
suffering aspiration pneumenia complicated with septicaemia.
otoscopy is strongly recommended at birth , initially in all
septic workups. Also, once the diagnosis of suppurative MEE
is made in infant under 1 month age we feel that
diagnostic tympanocentesis is indicated since the organisms
encountered in this age group are frequently resistent to
antibiotics used in older children. Initial antibiotic
coverage, while awaiting culture reports, should be expanded
to cover gram negative enteric organisms and B-stroptococci
in the outpatient department. Definitive treatment must be
individualized according to culture and sensitives.
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