Aetiology:

• This condition is commonly seen in children.
• Low socio-economic and poor hygienic conditions.
• Adenoid hypertrophy and chronic tonsillitis.
• Eustachian tube malformation.
• Palatal defects, palatal palsy.
• Allergy causing obstruction of eustachian tube.
• Viral infections of upper respiratory tract stimulate excessive secretory activity.
• Unresolved acute otitis media.

Pathogenesis:

OME is the result of middle ear dysventilation. There is an imbalance between gas gain through ET ventilation and gas loss through mastoid mucosal gas diffusion. This results in gas deficiency status in the middle ear which is the hallmark of OME.

Symptom:

• • Hearing loss:
    It is insidious in onset.
  • Earache:
    This is due to stretching of the tympanic membrane.



Sign:

• Tympanic membrane is often dull with loss of light reflex.
• Tympanic membrane may appear bulging with air bubbles.
• Mobility of tympanic membrane is reduced.

Treatment

• Medical:
  • 1 )Local decongestants- nasal drops like Oxymetazoline, Xylometazoline.
    2) Antihistaminics.
    3) Antibiotics.
    4) Valsalva’s maneuvre and steam inhalation for middle ear aeration.
• Surgical:
  • 1)Myringotomy.
    2)Grommet insertion.
    3)Cortical mastoidectomy may be required for removal of thick fluid from mastoid antrum.
    4)Adenoidectomy may be advised in children with recurrent effusion with enlarged adenoid tissue causing obstruction of the eustachian tube.