Pierre-Paul Gagnon, MD
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Understanding Serous Otitis Media
Understanding Serous Otitis Media
Serous otitis media is the medical term for fluid in the middle ear. Its symptoms, primarily hearing loss with pressure or pain is frequently experienced by children and adults alike, and typically follows an upper respiratory infection.
In most cases, the symptoms of serous otitis media disappear but in some children and adults, especially those with enlarged adenoids or allergies, symptoms may persist.
Generally, the problem is found to be a blockage of the Eustachian tube. This narrow canal connects the middle ear to the back of the nose and permits air to enter the middle ear cavity. This allows the hearing mechanism to function properly. When the symptoms of serous otitis media, such as hearing loss, persist, particularly at a time when a child is learning to speak, medical evaluation and treatment are recommended.
Eustachian Tube Function
An upper respiratory infection or allergy can interfere with Eustachian tube function. Tubes may swell shut, preventing drainage. In addition, adenoids at the back of the throat can become enlarged, blocking the Eustachian tube opening.
Understanding The Problem
Treatment of serous otitis media is designed to restore ventilation to the middle ear. Medications and allergy management may open the Eustachian tube and reduce fluid secretion. When needed, a myringotomy, with or without tube insertion, can be used to allow air to flow into the middle ear cavity.
Child Anatomy
A childs Eustachian tubes are shorter and more horizontal; the openings are often blocked by adenoids. In children, treatment improves Eustachian tube function, allowing air to enter the middle ear to restore hearing. Antihistamines, decongestants, antibiotics, nasal sprays, and allergy management may reduce swelling and fluid secretion. Surgical myringotomy, with or without tube insertion, and adenoidectomy may also be recommended.
Adult Anatomy
An adults Eustachian tubes are longer and more angled. Adenoids are usually small or absent. Antihistamines, decongestants, and steroids may be used to reduce swelling of the Eustachian tubes. Myringotomy and allergy management are sometimes recommended.
Surgical Treatment-Myringotomy
If hearing loss or fluid in the middle ear persists, an operation called a myringotomy with or without tube insertion may be recommended in order to remove middle ear fluid. This procedure requires a general anesthetic for young children. Also in children, surgery to remove enlarged adenoids adenoidectomy may be done at the same time as myringotomy.
After Myringotomy
An improvement in hearing is usually noticed right away and the incidence of middle ear infections should decline. In about 6-12 months, the myringotomy tube will automatically expel into the outer ear canal to be removed by the doctor during a follow-up visit.
After myringotomy it is important to keep water out of the ear, especially when the tube is in place. Water in the middle ear increases the chance of infection. Dont place the head underwater, or expose the ears directly to shower spray (wear a shower cap). To help prevent recurrences of serous otitis media, your doctor may recommend that you take decongestants and antihistamines at the first sign of nasal or sinus congestion.
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