Otitis media with effusion

• Serous otitis media = otitis media with effusion
• Middle ear fluid without acute signs of infection
• Due to obstruction of Eustachian tube -> air absorbed in middle ear -> negative pressure in middle ear -> exudate in middle ear
• Usually resolves by itself
• Risk factors
  • Cleft palate and other midface anomalies
  • 6 – 18 months
  • Impaired ventilation of middle ear
    • Upper respiratory viral infection with swelling
    • Obstruction of eustachian tube by tumor or adenoid hyperplasia
    • Tensor veli palatini dysfunction
  • Acute – up to 3 weeks
  • Subacute – 3 weeks – 3 months
  • Chronic – longer than 3 months
    • Cholesteatoma may form
• Clinical features
  • Mostly asymptomatic
  • Conductive hearing loss
  • Pressure in ear
  • Tinnitus
  • Balance problems
  • Retracted tympanic membrane
• Treatment
  • Conservative
    • Decongestants
    • Valsalva manoeuvre
  • Surgical
    • For chronic OME
    • Paracentesis
    • Myringotomy
    • Adenectomy

‎