Secretory otitis media

Introduction to secretory otitis media Secretory otitis media (secretoryotitismedia) is a non-suppurative inflammatory disease of the middle ear characterized by tympanic effusion and hearing loss. The middle ear effusion can be serous leakage or exudate, or mucus. The name of the disease is not uniform, there are called exudative otitis media, catarrhal otitis media, serous otitis media, serous-mucinous otitis media, non-suppurative otitis media. The middle ear is coated with a sticky gel, called glue ear. Secretory otitis media with numbness or blockage in the ear, hearing loss and tinnitus are the most common symptoms, often occur after a cold, or unconsciously occur, sometimes head position changes can improve hearing, there is self-listening enhancement, part The patient has mild earache and the child often appears to be obedient or inattentive. basic knowledge Sickness ratio: 0.5% Susceptible people: no special people Mode of infection: non-infectious Complications: adhesive otitis media tympanosclerosis

The cause of secretory otitis media

Eustachian tube dysfunction (30%):

Eustachian tube dysfunction is generally considered to be the underlying cause of this disease. Eustachian tube cartilage elasticity is poor, when the tympanic cavity is under negative pressure, the wall of the cartilage segment of the eustachian tube is prone to collapse, which is one of the anatomical and physiological foundations of the high incidence of otitis media with effusion in children. The cleft palate patients have no midline due to muscle. Attachment point, loss of contraction function, it is easy to suffer from this disease.

Infection (30%):

In the past, secretory otitis media was considered as aseptic inflammation. In recent years, it has been found that the positive bacterial culture in middle ear effusion is about 1/2-1/3, and the main pathogens are Haemophilus influenzae and Streptococcus pneumoniae. Bacteriology and histological examination results and clinical signs indicate that secretory otitis media may be a mild or low-toxic bacterial infection of the middle ear. The endotoxin of the bacterial product may be in the pathogenesis, especially in the process of chronic disease progression. To a certain role.

Immune response (30%):

Pediatric immune system is not fully developed, which may be one of the reasons for the high incidence of otitis media with effusion in children. There is an inflammatory mediator prostaglandin in the middle ear effusion, and the specificity of bacteria has also been detected in the effusion. Sexual antibodies and immune complexes, as well as the complement system, the emergence of lysosomal enzymes, etc., suggest that chronic secretory otitis media may be a pathological process mediated by anti-infective immunity, soluble immune complex damage to the middle ear mucosa (III Type allergic reaction can be one of the causes of chronic secretory otitis media.

Secretory otitis media prevention

Strengthen physical exercise, prevent colds, conduct health education, raise awareness of parents and teachers about this disease, and regularly conduct screening acoustic impedance tests for children under 10 years of age to actively treat nasal and pharyngeal diseases.

First, where the occurrence of occlusion in the ear, find the cause in time, and eliminate it in time, which is of great benefit to the recovery of the disease.

2. When the inflammation of the nose and nasopharynx interferes with the obstruction of the eustachian tube, the nose should be drenched with 1% ephedrine solution as soon as possible to make the nasal mucosa contract, the eustachian tube is smooth, and fresh air enters the middle ear, so that the ear is exuded immediately. absorb.

Secretory otitis media complications Complications , otitis media, tympanosclerosis

Secretory otitis media can progress to adhesive otitis media or complicated tympanosclerosis.

Secretory symptoms of middle ear inflammation Common symptoms Hearing loss Earache Tinnitus Hearing loss Bloody ear leak

Hearing loss and tinnitus are the most common symptoms in the ear. Hearing loss and tinnitus are the most common symptoms. They often occur after a cold, or unconsciously. Sometimes the head position changes, the hearing improves, there is self-listening enhancement, and some patients have light. Ear pain, children often appear to be obedient or inattentive.

symptom

(1) Hearing loss: hearing loss, self-improvement, head tilting or biased to the healthy side, because the effusion leaves the sinus, the hearing can be temporarily improved (displacement hearing improvement), when the effusion is thick, the hearing is not Because of changes in the head position, children often respond to the voice, the concentration is not concentrated, and the academic performance is reduced, and the parents receive the doctor. If the child is sick, the ear hearing is normal, but the long-term unconsciousness, but the physical examination begins. be found.

(2) earache: acute may have faint earache, often the patient's first symptom, can be persistent, can also be painful, chronic ear pain is not obvious, the disease is very related to ear occlusion or nausea The feeling of bloating can be temporarily relieved after pressing the tragus.

(3) Tinnitus: Mostly low-key intermittent, such as "squeaky" sound, snoring and running water, etc. When the head moves or yawns, when the nose is blowing, the sound of gas over the water may appear in the ear.

(4) The skin around the patient has a "woody" feeling, which is psychologically boring.

Examination of secretory otitis media

(1) Tympanic membrane: the relaxation part or the full tympanic membrane invagination, which is characterized by shortening of the light cone, deformation or disappearance, the hammer stem is displaced backward and upward, the humerus short protrusion is obviously protruding, and the angle between the front and the back fold becomes smaller, and the tympanic volume When the liquid is in the tympanic membrane, it loses its normal luster. It is single yellow, orange red oil is bright or amber, and the light cone is deformed or displaced. In chronic cases, it may be grayish blue or milky white. The tympanic membrane has dilated microvessels. The short protrusion is more than the sacral color. Embossed, if the liquid is serous and does not fill the tympanic cavity, the liquid level can be seen through the tympanic membrane. The liquid surface is like a curved hair, called the hairline, and the concave surface is upward. When the head position changes, it is grounded. The parallel relationship is unchanged, the air bubbles are visible through the tympanic membrane, the air bubbles can be increased after the eustachian tube is blown, and the tympanic membrane activity of the tympanic membrane is limited.

(2) The sound of the bottle stopper: the pressure is released after the tragus is pressed, and the ears are tested separately. The patient consciously has an ear sound similar to that of the bottle stopper.

(3) Hearing examination: the tuning fork test and the pure music listening valve test results show that the conductivity is paralyzed, the hearing loss is different from the government, and the heavy one can reach 40dB HL or so. Because the effusion volume often changes, the hearing threshold may have certain fluctuations. The loss is generally low frequency, but due to the structure of the middle ear ship and the impedance changes of the two springs, the high frequency air conduction and bone conduction hearing can also be objectively reduced. The hearing is improved after the effusion is discharged, and the sound guide is important for diagnosis. Value, flat type (B type) is a typical curve of secretory otitis media; high negative force type (C3 type) shows dysfunctional pharyngeal tube, some have tympanic effusion, and hearing impairment is significant, auditory brainstem response should be performed. Otoacoustic emission examination to determine if it has an effect on the inner ear.

(4) CT scan showed that the air cavity of the middle ear system had different degrees of density increase.

(5) Secretory otitis media can progress to adhesive otitis media or complicated tympanosclerosis.

Diagnosis and differentiation of secretory otitis media

Secretory otitis media should be differentiated from acute otitis media; the diagnosis of secretory otitis media should be confirmed by tympanogram. The clinical side should be monitored for the side of the secretory otitis media, duration, and whether there are combined symptoms and severity.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.