Otitis Media with Effusion (Glue Ear) Flashcards
What region of the ear is affected by Otitis media with effusion?
Middle
What is otitis media with effusion?
Accumulation of fluid within the middle ear without signs of infection
When can glue ear develop?
After an episode of otitis media which was not related to infection
Aetiology
Occurs when the Eustachian tube is narrow, blocked or the valves of the eustachian tube do not actively open
The middle ear fills with fluid,which over time (more than 3 months) becomes thicker (to the consistency of glue) and reduces vibrations of the ear drum and ossicles inthe middle ear. This may be visible as bubbles behind the eardrum when performing otoscopy
Presenting Symptoms
Reduced hearing; this can lead to speech and developmental problems in young children, especially if the condition is recurrent
Potentially tinnitus and/or balance issues
Earache and systemic upset (such as fever and malaise) are not usual
Prevalance
Common condition in children from 6 months to 4 years old, especially in winter.
The Eustachian tube in young children is narrow and positioned more horizontally than in adults, making drainage of fluid less effective
Causal Risk Factors
Age (due to physiology)
Genetics; children with a cleft palate, Down’s Syndrome, cystic fibrosis and allergic rhinitis are more prone to glue ear
An episode of acute otitis media (this is the cause of >50% of glue ear cases*)
Exposure to smoking or pollution
Reflux disease
Impaired Eustachian tube function
Management
‘Watchful waiting’, usually for 3 months. Spontaneous resolution of the condition is common
Autoinflation exercises to ventilate the middle ear
Surgical insertion of a grommet into the tympanic membrane to maintain middle ear ventilation. It is safely expelled from the ear 6-12 months later
What are the functions of the nose?
To warm and humidify inspired air
To trap and remove pathogens and particulate matter from the inspired air
To provide a sense of smell
To drain and clear the paranasal sinuses and lacrimal(tear) ducts
How many main regions of the nose are there?
3
What is the first region of the nose called?
Vestibule
What is the vestibule?
The first part of the nasal cavity which contains hairs that filter dust and other particulates
What is the second region of the nose called?
Respiratory region
What is the function of the respiratory region?
Warms and humidifying inspired air
Secretes mucus
How does the respiratory region help warm and humidify inspired air?
As air moves through this region, it is slowed down by three curved shelves of bone called turbinates (concha).
