OME Notes

OME (Otitis Media with Effusion)

Definition

• Accumulation of non-purulent fluid in the middle ear.
• Also known as Secretory OM, Glue ear, Serous OM, Mucoid OM.
• Common in school-going children.

Aetiology

• Malfunctioning of the Eustachian Tube (ET):
  • Adenoid hypertrophy
  • Rhinitis and sinusitis
  • Tonsillitis
  • Tumours of the nasopharynx
  • Cleft palate/palatal paralysis
• Increased Secretory Activity:
  • Allergy
  • Unresolved OM
  • Viral infections (adeno and rhinovirus)

Symptoms

• Hearing loss (CHL - Conductive Hearing Loss)
• Mild earaches
• Delayed or defective speech

Signs

• Dull Tympanic Membrane (TM) with loss of light reflex.
• TM may be yellow, bluish, or grey.
• Retracted TM, sometimes may bulge.
• Fluid level, air bubbles
• Restricted TM mobility (pneumatic otoscopy)

TFTs (Tuning Fork Tests)

• Rinne negative
• Weber lateralized to affected ear

Medical Treatment

• Nasal decongestants
• Antihistamines
• Antibiotics (for tonsillitis, sinusitis, adenoiditis)
• Middle ear aeration (Valsalva, chewing gum, ET catheterization)

Surgical Treatment

• Myringotomy & aspiration of fluid
• Grommet insertion/ventilation tube/tympanostomy tube
• Treatment of causative factor (adenoidectomy, tonsillectomy, cleft palate repair)