SEROUS OTITIS MEDIA

Description

  • Insidious condition characterized by accumulation of non purulent effusion in the middle ear cleft without signs of acute infection
  • Occurs after an episode of acute otitis media or in the context of Eustachian tube dysfunction
  • Young children presenting with hearing problems, often describe sound as muffled associated with aural fullness and with upper respiratory tract infections may be serous otitis media

Etiology

  • Malfunctioning of eustachian tube
    • Adenoid hyperplasia
    • Chronic rhinitis and sinusitis
    • Chronic tonsillitis
  • Allergy - Seasonal or perennial allergy
  • Unresolved otitis media
  • Viral infections

Types

Symptoms

  • The disease usually affects children of 5–8 years of age
  • Hearing loss
  • Delayed and defective speech
  • Mild earaches

Sequelae of chronic secretory otitis media

  • Atrophic tympanic membrane and atelectasis of the middle ear
  • Ossicular necrosis
  • Tympano sclerosis
  • Retraction pockets and cholesteatoma

Investigation

Otoscopic findings

  • Tympanic membrane is often dull and opaque with loss of light reflex
  • Tympanic membrane may show varying degree of retraction
  • Fluid level and air bubbles may be seen when fluid is thin and tympanic membrane is transparent

 Hearing tests

  • Tuning fork tests show conductive hearing loss
  • Audiometry - There is conductive hearing loss of 20–40dB
  • Impedance audiometry -reduced compliance and flat curve with a shift to negative side
  • X-ray mastoids - There is clouding of air cells due to fluid

Treatments

Medical

  • Decongestants
  • Anti allergic measures
  • Antibiotics

Surgical

  • Myringotomy and aspiration of fluid
  • Grommet insertion
  • Tympanotomy or cortical mastoidectomy

Ayurvedic Treatment

  • Management of URTI
  • Advice to avoid Cold Items

Internal Medicines

For Associated Respiratory tract infections

  • Dashamoola katutraya Kashaya
  • Vyoshadi vataka

To relieve infection

  • Panchathiktaka kashaya
  • Guggulu pancha pala choorna
  • Kaisora guggulu
  • Mahatikthaka gritha
  • Guggulu thikthaka gritha

Procedures

  • Kabala - Triphala kashaya + Trikatu choorna
  • Ear toileting
  • Karnadhoopana - Guggulu varthi / Haridra
  • Karnapichu - Surasa rasakriya
  • Jaloukavacharana over ear

Department

Salakya - ENT

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