OTITIS MEDIA WITH Shaheer Hassan

EFFUSION
SYN. SEROUS OTITIS MEDIA,
SECRETORY OTITIS MEDIA, MUCOID
OTITIS MEDIA, “GLUE EAR
This is an insidious condition characterized by
accumulation of nonpurulent effusion in the middle ear
cleft.

Often the effusion is thick and viscid but sometimes it

may be thin and serous. The fluid is nearly sterile. The
condition is commonly seen in school-going children.
PATHOGENESIS AND
AETIOLOGY
Malfunctioning of Eustachian Tube.
Increased secretory activity of middle ear mucosa.
1. Malfunctioning of eustachian tube.
(a) Adenoid hyperplasia. (b) Chronic rhinitis and sinusitis. (c) Chronic tonsillitis. (d) Benign and malignant tumours
of nasopharynx. (e) Palatal defects, e.g. cleft palate, palatal paralysis.

2. Allergy.
3. Unresolved otitis media.
4. Viral infections.
 CLINICAL FEATURES
1. Symptoms.
(a) Hearing loss.
(b) Delayed and defective speech.
(c) Mild earaches.
2. Otoscopic findings.
Tympanic membrane may appear yellow, grey or bluish in colour.
Thin leash of blood vessels may be seen along the handle of malleus or at the periphery of
tympanic membrane.
Tympanic membrane may show varying degree of retraction. Mobility of the tympanic
membrane is restricted.
HEARING TEST
1. Tuning fork tests show conductive hearing loss.
2. Audiometry.
3. Impedance audiometry.
4. X-ray mastoids.
TREATMENT
TREATMENT The aim of treatment is removal of fluid and prevention of its
recurrence.

1. MEDICAL
(a) Decongestants.
(b) Antiallergic measures.
(c) Antibiotics.
(d) Middle ear aeration.
TX CONTD
2. SURGICAL.
When fluid is thick and medical treatment alone does not help, fluid must be
surgically removed. (
a) Myringotomy and aspiration of fluid.
b) Grommet insertion.
c) Tympanotomy or cortical mastoidectomy.
(d) Surgical treatment of causative factor.
SEQUELAE OF CHRONIC
SECRETORY OTITIS MEDIA
1. Atrophic tympanic membrane and atelectasis of the middle ear.
2. Ossicular necrosis.
3. Tympanosclerosis.
4. Retraction pockets and cholesteatoma.
5. Cholesterol granuloma.
Thank you.