外语渗出性中耳炎

OTITISMEDIAWITH

EFFUSION----(OME)1整理ppt一、overviewOtitismediawitheffusion(OME)ischaracterizedbyaccumulationoffluidinthemiddleear,conductivehearingloss,andisakindofnon-purulentdiseasesofmiddleear.2整理pptOMEoccursasaresultofdecreasedventilationofthemiddleearormastoidair-cellsystemthroughtheeustachiantube.

3整理ppt

SerousOtitisMedia

GlueEarNon-purulentOtitisMedia

OMEiscalledothernames:4整理pptOMEisoneofthemostcommonlyresultingindeafnessamongchildren.

OMEoccursinadulttoo.

5整理ppt6整理ppt7整理pptFunction

oftheeustachiantubeTheeustachiantubeisessentialinmaintainingahealthy,well-aeratedthemiddleear.8整理ppt9整理pptTheeustachiantubeventilatesthemiddleear,protectsitfrompathogenicorganismsinthenasopharynx,equilibratespressureacrossthetympanicmembrane,andallowsdrainageofsecretionsfromthemiddleearintonasopharynx.

10整理ppt

Atrest,theeustachiantubeisclosed.Duringswallowing,yawning,orsneezing,thenasopharyngealorificeofeustachiantubeisopenedtransiently.

11整理pptTheanatomyoftheeustachiantubeofinfantsisdifferentfromadult’s.Theinfantileeustachiantubeismorehorizontalorientation,shorterlength,andmorepatulousconfigurationthanadult.12整理ppt二、PathogenesisAnyprocessthatinterfereswithnormalopeningofproximal(nasopharyngeal)endoftheeustachiantubeormucociliaryclearancemechanismcausesOME13整理ppt(1)、mechanicalobstruction:largeorinfectedadenoidsturbinatehypertrophyneoplasmofnasopharynxnasopharyngealedemaorinflammation

14整理ppt(2).AllergyAllergyreactionaffectsbothmucociliaryclearancemechanismandnormaleustachiantubeopening.15整理ppt(3).Abnormaleustachiantube

anatomySuchas:cleftpalatedeformitiescanimpaireustachiantubefunction.

16整理ppt

Functionaldisordersofeustachiantube→negativepressureintympaniccavity

→veinsinmucousbedilatedandbecongested→vesselspermeancebeincreased→seruminvesselsbeexuded

intotympaniccavity→

middleeareffusion

17整理ppt三.ClinicalPresentation

SymptomsConductiveHearingLoss,

Earache,

Earfullness,Tinnitus

.18整理pptPhysicalExaminationTympanicMembranetoberetracted,dull,opaque.colorcanrangefrom:lightpinktoamberandevendarkblue.

19整理ppt20整理ppt21整理ppt22整理ppt

AudiometricTesting

reveals:Mild~middlelevelsofconductivehearingloss

23整理pptAudiogram24整理ppt

AcousticImmittance25整理pptNormalacousticimmittanceis“type_A〞curve.Thecurvehaspeakat“O〞Pascalpressurepoint.

OME’sAcousticimmittanceis“type_B〞curve.Itisflattympanometriccurve26整理ppt四、Diagnosis(一)、History:

Somepatientssufferedupperrespiratorytractinfectionbefore1~2weeks,orsufferedrhinitis,adenoidshypertrophyet.

Perennial.

27整理ppt

〔二〕、Clinicalpresentation:

hearingimpairment

tinnitus

earobstruction

Earache(earpain)

28整理ppt(三)、Physicalexamination

tympanicmembraneberetracted

tympaniccavityeffusion

29整理ppt〔四〕、AudiometricTestingMild~middlelevel

conductivehearingloss〔五〕、AcousticImmittance

“type_B〞curve

30整理ppt

1、tympanosclerosis

2、glomusjugularetumor3、cerebrospinalotorrhea

４、nasopharyngealcarcinoma

五、DifferentialDiagnosis31整理ppt

六、Management

PrinciplesofManagement：

〔一〕、Eliminatemiddleeareffusion,improvemiddleearventilationanddrainage.

32整理ppt

(1)、Keepexpeditenasalcavity

andeustachaintubeChild:0.5%ephedrineandfuracillinesolution

Adult:1%ephedrineandfuracilline

solution

33整理ppt(2)、Eustachiantubeinsufflation

Valsalvamethod

Politzermethod

Catheterization

34整理ppt(3)、PunctureofTympanum35整理ppt(4)、Tympanotomy36整理ppt

(5)、TympanostomyTube37整理ppt

〔二〕、Managementofetiology

Treatmentnasalandnasopharyngealdiseases

Example:adenoidhypertrophy__

adenoidectomy

radiationofnasopharyngealcarcinoma

38整理ppt〔三〕、AntibiotictreatmentPenicillin

Cephradine

Treatmentmaintains3~5daysbyoral(mild)orbyinjection,IV(severe)

39整理ppt〔四〕、SteroidtreatmentDexamethasone:

Adult:5~10mg/day,3~5days,by

injection,IV.

40整理ppt

七、PreventionExercise

Preventflu

Treatmentnasalandnasopharyngealdiseases41整理ppt5.Questions1.Whatistheotitismediawitheffusion(OME)?2.WhataretheessentialcausesofOME?