Middle Ear Fluid Accumulation

Middle ear infections are inflammations that occur in the middle ear cavity behind the eardrum. The cause is usually viruses or bacteria. It often occurs following a deterioration in the function of the eustachian tube, which provides ventilation to the middle ear, due to a recent cold or an allergic problem. One or both ears may be affected simultaneously. Since the middle ear has not fully completed its anatomical development in young children, ear infections are more common due to the differences in Eustachian canal functions and anatomy. Especially; ,

Middle ear infections are more common in children who live in poorly ventilated crowded environments and are exposed to cigarette smoke.

Although middle ear infections are less frequent, they are also seen in adolescence and adults. The most common middle ear infections in children are serous/effusion otitis media and acute otitis media.

Serous Middle Ear Inflammation (Serous Otitis Media, Otitis Media with Effusion)

Normally The most important reason is the deterioration of the functions of the Eustachian tube, which adjusts the middle ear pressure by opening for a short time with each swallow, due to reasons such as viral infections and allergic reactions. As a result, the middle ear cannot be ventilated, and as a result of fluid withdrawal from the tissues due to the negative pressure created by the accumulation of ear secretions and the absorption of air by the tissues, the middle ear fills with fluid (serous otitis). As a result of the darkening of the mucosal secretion due to long-lasting negative pressure, secretory otitis media, a more chronic condition, occurs. Because of this fluid, the eardrum cannot vibrate properly and the child develops hearing loss. This mild hearing loss causes various changes in the child's behavior: If this problem becomes chronic, it may lead to a delay in the child's mental development and the start of speaking. The main findings observed in a child with hearing loss are as follows:

He turns the television volume up too much or sits too close to the television.

He does not immediately respond to what is said or does not pay any attention to it because he cannot hear it properly. .

We told the teacher at school His interest in studies decreases and he begins to fail in his classes. Middle ear fluid and hearing loss should be investigated in lazy children at school

Speech disorders may occur due to the inability to hear consonants especially "s" and "z" well.

CAUSES OF SEROUS OTITIS

• Adenoid growth and filling of the nasal cavity (adenoid vegetation)
• Nose and sinus infections
• Acute middle ear infections
• Allergy, immune system deficiency
• Rarely, they are tumors that affect the eustachian canal function

SEROUS OTITINA DIAGNOSIS

Serous otitis is a silent disease and does not usually present with obvious complaints such as fever, vomiting, and pain. The diagnosis is often made during examinations due to adenoid-related complaints or as a result of suspicion of hearing loss.

The eardrum is dull, thickened and has increased vascularity on it. Depending on the duration of the problem, there may be shrinkage in the membrane, adhesion to the middle ear structures, and dark color changes. The disease often affects both ears. Hearing loss may not be noticed in unilateral serous otitis. In these patients, symptoms such as imbalance, difficulty in sports activities, and difficulty in walking may be observed due to the impact of the balance center. As diagnostic aids, measurement of middle ear pressure, measurement of hearing reflexes, and hearing tests are performed in children who can adapt. Hearing loss is conductive. Rarely, nerve type loss may occur due to substances secreted by microorganisms in the middle ear.

TREATMENT

Drug treatment:

Initially, antibiotic treatment is applied. Medicines that reduce mucosal swelling and thin the mucus consistency can be used. Anti-allergic treatment should be added to patients diagnosed with allergy. Activities such as chewing gum and blowing up balloons can greatly help the function of the eustachian tube. In this respect, simple systems called Otovent, which use air to inflate balloons through the nose, can be much more useful. It may be appropriate not to send them to this environment for about 1 month. It should be recommended that bottle-fed children be fed in a semi-sitting position.

Changes can be made in the treatment planning, taking into account the frequent occurrence of the disease in parallel with the increasing viral infections in the autumn and winter periods.

If the treatments applied in six to eight weeks are not successful and there is hearing loss above 20-25 dB, surgical treatment is preferred. If there is thinning, collapse, pocketing in the eardrum, nerve type loss or balance disorder, direct surgical treatment can be chosen.
 

Surgical treatment:

In surgical treatment, a ventilation tube is inserted into the eardrum, following which the hearing loss heals immediately. Additionally, adenoids and tonsils can be removed if necessary. The ventilation tube is applied to children under general anesthesia, it generally remains in the eardrum for 8-12 months and then falls out on its own or is removed by the doctor (grommed tubes that do not fall out after 15 months). Generally, it is done in office conditions without the need for any extra surgical intervention to remove the tube. With these treatments, most patients recover fully. Rarely, repeated tube applications or permanent tube application may be required (T tube). Allergies and immune system functions should be evaluated, especially in children with recurrent serous otitis complaints.

It is generally okay for children with tubes inserted into the eardrum to swim in the sea as long as they do not dive more than one meter in areas where the water is clean, but especially in swimming pools and soapy water. While taking a shower or bath, the external ear canal should be closed with petroleum jelly cotton or a suitable earplug to prevent water from entering the middle ear from the tube.


 

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