5. Serous otitis media (acute, chronic)

From greek.doctor
  • 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