NON SUPPURATIVE OTITIS MEDIA
Definition A clinically non-infective non-suppurative form of fluid collection behind an intact TM.Otitis media with effusion
Other Synonyms Secretory om. Exudative om. Serous om. Glue ear.Patho-physiology
• Acute ET obstruction >ME vacuum vascularengorgement transudation of serous fluid fromsubepithelial vessels >>Acute serous OM.• Insiduous ET obstruction increased CO2 tension > glandular hypertrophy > production of viscid mucus > glue >> chronic secretory OM.Occlusion of the eust.tube which may result from : a- adenoid hypertrophy b- salpingitis c- stricture or adhesion of tubal orifice after surgery/ adenoidectomy. d- ulceration or neoplasm of the post nasal space involving the pharyngeal orifice e- paralysis of the palatal muscles
unresolved acute om. Viral infection of the middle ear cleft. Allergy e,g: hay fever. Cleft palate & its` repair if the pterygoid hamulus is fractured .
Deafness : Conductive Hearing better in supine than in errect. Tinnitus : Bubbling noise in the ear Impaired speech & language development
History of hearing loss obtained from parents in young children Feeling of fullness in the ear following flu. Behavioral& scholastic difficulties , insularity, shouting or increasing TV volume.
TM. Is dull & retracted .Horizontal crescent hair lineAir bubbles on blowingGrey to ... Black // blue drumThin serous to … Glue Mobility can be assessed by blowing or Siegel's or pneumatic otoscope
Medical R,: * 50% may resolved spontaneously within 3months * elimination of the aetiological & predisposing factors. * many trials of R, with AB, steroid, decongestant, antihistamines & prostaglandin inhibitors .