Otitis media with effusion

Question 1

AKA?

Answer 1

Serous otitis media

Glue ear

Question 2

What?

Answer 2

Characterized by collection of fluid within middle ear space without signs of acute inflammation
Assoc. with Eustachian tube dysfunction or obstruction

Question 3

Mechanism by which this occurs?

Answer 3

Blocked Eustachian tube
-> reduced pressure of middle ear -> Eustachian tube is not providing additional gas when opens on swallowing -> if continues longterm fluid becomes thicker

Question 4

Risk factors?

Answer 4

Cleft palate
Down’s syndrome
Primary ciliary dyskinesia
Allergic rhinitis

Question 5

Who?

Answer 5

Children 2-5

Question 6

Causes to consider in adults?

Answer 6

Rhinosinusitis
Nasopharyngeal carcinoma
Nasopharyngeal lymphoma

Question 7

Clinical features?

Answer 7

Hearing loss or speech delay
Little association with otalgia
Fluid – clear or cloudy
Conductive hearing loss with flat tympanogram

Question 8

Examination?

Answer 8

Otoscopy
Normal tympanic membrane
No inflammation or discharge
Effusion can be serous, mucoid, purulent

Question 9

When is effusion more likely?

Answer 9

If abnormal colour of drum (yellow, amber, blue)
Loss of light reflex
Opacification of drum
Air bubbles or an air/ fluid level
A retracted, concave, Andrew drum

Question 10

Investigations?

Answer 10

Audiometry

Tympanometry

Question 11

Non- surgical management?

Answer 11

Acute observation 6-12 weeks
Hearing aids
Autonflation

Question 12

Surgical management?

Answer 12

Grommet’s insertion