Fluid in the middle ear Flashcards
How is fluid in the middle ear detected?
otoscopy - fluid level or bubbles behind the drum
Tympanometry
What is glue ear known as?
otitis media with effusion
How does glue ear usually present?
hearing impairment noticed by parents
What is glue ear associated wi
URTI
Oversized adenoids
Narrow nasopharyngeal secretions
What groups is glue ear more common in?
Boys Downs Winter Atopy Children o smokers Primary ciliary dyskinesia
what would you ask about in the history w a child w suspected glue ear?
poor listening or speech language delay inattention poor behaviour ear infections/URTI balance school work
What are the signs of glue ear?
eardrum:
- retracted or bulging
- dull, grey or yellow
- bubbles or fluid level
What tests can be done for someone with glue ear?
Audiogram - look for conductive defects
Impedance audiometry - flat tympanogram
What is the conservative treatment of glue ear?
active observation for 6-12weeks
spontaneous resolution is common
when are hearing aids indicated for treatment of glue ear?
persistent bilateral OME and hearing loss if surgery is not accepted
When is auto inflation indicated as treatment of glue ear?
during active observation period for children w OME (older as more likely to cooperate)
wHat does auto inflation involve? What is the alternative in older children?
blowing up a balloon via the nostril 2-3 times a day, so ventilates the middle ear, equilibrating pressure and allowing drainage of fluid
Valsalva manoeuvre in older children w out a balloon
What are the surgical options for OME?
myringotomy + insertion of grommets
What are complications of grommets?
infections
tympanosclerosis
How would u treat infections related to OME?
aural toilet
abx/steroid ear drops
grommet removal?
