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    Otitis Media With Effusion

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    cadburydaniel
    Otitis media with effusion is characterized by an accumulation of nonpurulent fluid in the middle ear cavity. It commonly affects children between 5-8 years old. The fluid may be thick and viscous or thin and serous. It occurs due to malfunction of the eustachian tube which prevents proper ventilation and drainage of the middle ear, or increased secretory activity of the middle ear mucosa. Symptoms include hearing loss, delayed speech development, and mild earaches. Diagnosis involves examination of the opaque tympanic membrane and tests showing conductive hearing loss. Treatment includes medications to reduce edema, antibiotics, and sometimes myringotomy with tube insertion or adenoidectomy to drain the fluid.

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    Otitis Media With Effusion

    Uploaded by

    cadburydaniel
    14 views16 pages
    Otitis media with effusion is characterized by an accumulation of nonpurulent fluid in the middle ear cavity. It commonly affects children between 5-8 years old. The fluid may be thick and viscous or thin and serous. It occurs due to malfunction of the eustachian tube which prevents proper ventilation and drainage of the middle ear, or increased secretory activity of the middle ear mucosa. Symptoms include hearing loss, delayed speech development, and mild earaches. Diagnosis involves examination of the opaque tympanic membrane and tests showing conductive hearing loss. Treatment includes medications to reduce edema, antibiotics, and sometimes myringotomy with tube insertion or adenoidectomy to drain the fluid.

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    OTITIS MEDIA WITH EFFUSION

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    Otitis media with effusion is characterized by an accumulation of nonpurulent fluid in the middle ear cavity. It commonly affects children between 5-8 years old. The fluid may be thick and viscous or thin and serous. It occurs due to malfunction of the eustachian tube which prevents proper ventilation and drainage of the middle ear, or increased secretory activity of the middle ear mucosa. Symptoms include hearing loss, delayed speech development, and mild earaches. Diagnosis involves examination of the opaque tympanic membrane and tests showing conductive hearing loss. Treatment includes medications to reduce edema, antibiotics, and sometimes myringotomy with tube insertion or adenoidectomy to drain the fluid.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    14 views16 pages

    Otitis Media With Effusion

    Uploaded by

    cadburydaniel
    Otitis media with effusion is characterized by an accumulation of nonpurulent fluid in the middle ear cavity. It commonly affects children between 5-8 years old. The fluid may be thick and viscous or thin and serous. It occurs due to malfunction of the eustachian tube which prevents proper ventilation and drainage of the middle ear, or increased secretory activity of the middle ear mucosa. Symptoms include hearing loss, delayed speech development, and mild earaches. Diagnosis involves examination of the opaque tympanic membrane and tests showing conductive hearing loss. Treatment includes medications to reduce edema, antibiotics, and sometimes myringotomy with tube insertion or adenoidectomy to drain the fluid.

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    OTITIS MEDIA WITH EFFUSION

    Heba Hudifa
    20M067
    • This is an insidious condition characterized by
    accumulation of nonpurulent effusion in the
    middle ear cleft.
    • Effusion maybeThick and viscid/Thin and serous
    • INCIDENCE:Commenly seen in children (5-8yrs)
    Pathogenesis
    • Two mechanisms

    1. Malfunctioning of ET: Pressure change occur in


    middle ear thereby fails to aerate the middle ear
    and drain the fluid leading to accumulation of
    fluid.

    2. Increased Secretory activity of Middle Ear:


    Biopsies of middle ear mucosa in these cases
    have confirmed increase in number of mucus or
    serous secreting cells.
    AETIOLOGY
    1. Malfunctioning of ET:
    Causes include;
    • Adenoid hyperplasia
    • Chronic rhinitis and sinusitis
    • Chronic tonsillitis
    • Benign and malignant
    tumours of nasopharynx
    • Palatal defects, e.g. cleft
    palate, palatal paralysis.
    • Down’s syndrome
    2. Allergy:
    Seasonal or perennial allergy to inhalants or
    foodstuff is common in children. This not only
    obstructs eustachian tube by oedema but may
    also lead to increased secretory activity as
    middle ear mucosa acts as a shock organ in
    such cases
    3. Unresolved Otitis media:
    Inadequate antibiotic therapy in acute
    suppurative otitis media may inactivate infection
    but fail to resolve it completely. Low-grade
    infection lingers on. This acts as stimulus for
    mucosa to secrete more fluid. The number of
    goblet cells and mucous glands also increase
    4. Viral Infection:
    Adenovirus and rhinoviruses of upper
    respiratory tract may invade middle ear
    mucosa and stimulate it to increased secretory
    activity
    Clinical Features
    SYMPTOMS:
    • Hearing loss - Insidious in onset and rarely
    exceeds 40 Db. Accidentally discovered during
    audiometric screening tests.
    • Delayed and defective speech- Because of
    hearing loss, development of speech is delayed
    or defective
    • Mild earaches- There may be history of upper
    respiratory tract infections with mild earache
    OTOSCOPIC FINDINGS:
    ▪Tympanic membrane is dull and
    opaque with loss of light reflex
    ▪Thin leash of blood vessels seen
    along handle of malleus or at
    periphery of TM
    ▪TM show varying degree of
    retraction(full/slightly bulged in
    posterior part)
    ▪When TM is transparent fluid level
    and air bubbles seen
    ▪Valsalva manoeuvre produce
    crackling sound
    ▪Mobility of TM reduced
    ▪Appear yellow/grey/bluish color
    HEARING TESTS
    1. Tuning fork tests- show conductive hearing loss

    2. Audiometry- There is conductive hearing loss of


    20– 40 Db maybe associated with SNHL

    3. Impedence audiometry- Presence of fluid is


    indicated by reduced compliance and flat curve
    with a shift to negative side

    4. X-ray mastoids or CT temporal bone- There is


    clouding of air cells due to fluid.
    MEDICAL: TREATMENT
    • Topical Decongestants(nasal drops,sprays,systemic)
    helps to relieve oedema of ET.
    • Antiallergic measures(antihistamnes/steroids) used
    in cases allergy
    • Antibiotics useful in URTI or unresolved acute
    suppurative otitis media

    • Middle ear Aeration-Perform Valsalva


    manoeuvre.Sometimes, politzerization or eustachian
    tube catheterization has to be done that helps to
    ventilate middle ear and promote drainage of fluid.
    Children can be given chewing gum to encourage
    repeated swallowing which opens the tube
    SURGICAL:
    1. Myringotomy:
    ▪ An incision is made in
    tympanic membrane and
    fluid aspirated with suction
    ▪ Thick mucus require
    mucolytic
    agents(chymotrypsin) to
    liquify before aspirating
    ▪ In case of thick glue like
    secretions based on beer can
    principle 2 incisions is made
    one at anteroinferior another
    at anterosuperior quadrent
    of TM
    o Grommet insertion:
    If myringotomy and aspiration combined with
    medical measures have not helped a grommet is
    inserted to provide continued aeration of middle
    ear
    o Tympanotomy/cortical mastoidectomy:
    It is sometimes required for removal of loculated
    thick fluid or other associated pathology such as
    cholesterol granuloma
    o Surgical treatment of Causative factor:
    At the time of myringotomy, adenoidectomy,
    tonsillectomy and/or wash-out of maxillary antra
    may be required
    COMPLICATIONS:
    • Atrophic Tympanic Membrane and Atelectasis of
    The Middle Ear
    • Ossicular Necrosis
    • Tympanosclerosis
    • Retraction Pockets and Cholesteatoma
    • Cholesterol Granuloma
    REFERENCES
    • Diseases of Ear,Nose,Throat and head and
    neck surgery Dhingra ,8th edition
    • Google image
    THANK YOU

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