5. Serous otitis media (acute, chronic)
- 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
- Conservative