Otitis Media With Effusion

Posted by e-Medical PPT Saturday, June 2, 2012
What is Otitis Media With Effusion?
Presence of fluid without signs or symptoms of ear infection
Decreased TM mobility and barrier to sound conduction
2.2 million yearly diagnoses

Etiology and Epidemiology
Epidemiology:
 90% of children suffer from OME before school age (usually 6 months to 4 years)
 30-40% of children with recurrent OME
 5-10% last greater than 1 year
Etiology:
 Poor Eustachian Tube Function
 Inflammatory response following AOM

Diagnosis of OME
Strong Recommendation – Pneumatic otoscopy should be used as the primary diagnostic method for OME.
Option – tympanometry should be used to confirm diagnosis
Important to distinguish from AOM – redness of TM should not be indication for antibiotics

Up to 5% of OME cases will have TM redness
Pneumatic otoscopy sensitivity 94%, specificity 80% versus myringotomy as gold standard
When diagnosis of OME is uncertain tympanometry may be used as an adjunt
Pneumatic otoscopy generally causes no discomfort in the absence of AOM

Associated signs and symptoms:
Ear pain, popping, fullness
Ear rubbing, irritability, sleep disturbances
Failure to respond appropriately to voices or sounds
Hearing loss
Recurrent AOM
Problems with school performance
Balance problems, motor delay
Delayed speech, language...

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