Chronic otitis media

Question 1

Define chronic otitis media with effusion (OME).

Answer 1

Chronic mucoid or serous effusion in the tympanic cavity in the absence of infection lasting for >3 months

Question 2

What are the clinical features of chronic OME?

Answer 2

• May be asymptomatic
• Painless sensation of pressure or ‘fullness’ within the affected ear
• Conductive hearing loss
• Speech and language impairment

Question 3

What investigations should be done if chronic OME is suspected?

Answer 3

1. Pneumatic otoscopy
   - intact TM
   - TM may be opaque, yellow, retracted
   - Air fluid level behind TM
   - Impaired mobility of TM
2. Audiometry
   - Do this if OME >3 months or if there is speech impairment
   - Will show conductive hearing loss of 20-40 dB

Question 4

How is chronic OME treated?

Answer 4

*most children only require active observation for 3 months

• <4 y.o: tympanostomy tube
• > /=4 y/o: tympanostomy tubes and/or adenoidectomy