Otitis Media With Effusion (OME)

1. Otitis Media With
Effusion (OME)
Presented by Dr. Mohammad Najibulla Rahaman
Department of ENT and HNS
NMCTH, Birgunj

2. Definition
 Otitis media with effusion is characterized by presence of
non purulent fluid in the middle ear cleft.
 Several synonyms are used depending upon the type of fluid
present in the middle ear cleft.
 These synonyms are :
 Serous otitis media
 Glue Ear
 Chronic Secretory otitis media
 Mucoid otitis media

3. Etiology
ET dysfunction
ET obstruction
 Tumours (nasopharyngeal carcinoma)
Adenoid hyperplasia
Palatal defects
Oedema during radiation therapy
Spread of infection
Chronic tonsillitis
Chronic rhino sinusitis

5. Etiology cont.
Increased Secretions
Allergy
Cigarette smoke (specially mother
smoking)
Infection
 unresolved AOM
Viral infections

6. Pathogenesis
Mechanism responsible for this are
 1. Malfunctioning of Eustachian tube
 ET fails to aerate middle ear and unable to drain the
fluid.
 2. Increased secretory activity of middle ear
mucosa
 Biopsy of ME mucosa show increased number of mucus
or serous-secreting cells.

7. Clinical Features
Symptoms
Hearing impairment
Speech and language disorders in
children
Rubbing the ears with fingers
Recurrent otalgia if child has recurrent
AOM

8. Clinical Features
 Signs
Shiny, pearly gray appearance of pars tensa is absent
and color of the TM is either auburn or pink due to
increased vascularity of the TM
Generalized retraction of TM
TM is thickened or rarely thinned out in long-standing
cases
Mobility of TM is decreased
Fluid level or air bubbles are occasionally seen through
the TM
Tuning fork tests show conductive hearing loss.

9. Treatment
Medical Treatment
 Topical or systemic decongestant and antihistamines → for ET
edema.
 Antibiotics for URTI (Co-amoxiclav).
General Measures
 frequently perform valsalva manoeuvre, offer chewing gum, ET
cathetherization.
 with these measures, observe the patient on a monthly follow-up
for 3 months. This is because most of the OME resolved by 3
month.

10. Surgical treatment
 If OME does not resolve in about 3 months, ventilation tubes (also known as
tympanostomy tube or grommet)should be inserted. An incision(myringotomy) is made
either in the anterosuperior or in the anteroinferior quadrant of pars tensa, fluid is
sucked out and the ventilation tube inserted

11. Sequelae of OME
 T.M. atrophy and atelectasis
 Adhesive otitis media
 Tympanosclerosis
 Ossicular necrosis

12. Thank You