Diseases of The Middle Ear
Following statements are true about otitis media with effusion in a child: [DNB June 2011]
|A||Immediate myringotomy is done|
|C||The effusion of middle ear is sterile|
|D||Most common cause of deafness in a child in day care patients|
Most common cause of deafness in children (specially school going children)? Current otolaryngology
Characterised by accumulation of non purulent, sterile fluid in middle ear",
Clinical feature; •. Conductive deafness - Presenting symptom?
• Delayed and defective speech
Tympanogram; Type B curveQ / flat or dome shaped curve",
Management; Grommet insertion is the TOCQ but should not be performed immediately.
According to Ghai
a. "Since 50% of serous middle ear etiuskmsresotve spontaneously within3 months, newly diagnosed effusions should be observed for thisperiod in nearly all cases.
b. Use of antihistilminicsanc;ldecongestantshas been abandoned based on adequate scientific data demonstrating Jack of efficacy . The benefit.of brief steroid administration is.unproven.
c. .If,effusion persists beyond 3 months, tympanostomy tube insertion may be considered for significant hearing loss (>25 dB). Other indications of tube placement are ear discomfort or pain altered behaviour, speech delay, recurrent acute otitis media or impending cholestecttoma formation from tympanic membrane retraction
Indications for early insertion of Tympanostomy tube/ grommet tube:
Cases where spontaneous resolution is unlikely as predicted by season of presenting to OPD (i.e between July to December) and a B/L hearing impairment of>30dB
It is causing significant delay in speech and language development
OME is present inan only hearing ear.
Recurrent otitis mediA.