By definition, it is the accumulation of fluid in the middle ear cavity behind the eardrum without any inflammatory findings (such as fever, redness of the eardrum). This fluid is not a fluid coming into the middle ear from outside. Generally, after a previous otitis media, fluid accumulation occurs in the middle ear as a result of the increase in the number of fluid-secreting cells in the middle ear. In these patients, as a result of the involvement of the Eustachian tube in the disease, the fluid accumulated in the middle ear cannot flow into the nasal passages. Over time, the liquid thickens and turns into glue consistency. Filling of the middle ear with fluid affects the ventilation of the ear cavity and creates a negative pressure in the middle ear. This negative pressure causes the eardrum to collapse inward over time. If not treated properly, this collapse in the membrane will progress, causing the membrane to stick to the middle ear cavity and damaging the ossicles in the middle ear. After this stage, much more serious problems await the patient.
What are the signs and symptoms? How is the diagnosis made?
It is usually a childhood disease. The disease usually has an insidious course in its initial phase. Older children complain of fullness in the ear, occasional ear pain and hearing loss. Since young children cannot express their complaints, the most typical finding is that the child constantly plays with his ear. These children are more irritable and lack attention. Again, the most typical finding is a decrease in hearing. During the examination, the physician sees that the eardrum has lost its natural color and become dull. While the membrane is pushed out by the liquid effect in the initial period, a collapse of the membrane occurs in the later period. Clinical examination is usually sufficient to make the diagnosis. However, a hearing test and middle ear pressure measurement must be performed.
Treatment
Most of the fluid in the middle ear is usually absorbed and disappears within 3 months. During this process, the patient can be monitored without medication or some medications can be used. The most frequently preferred and proven effective medicines are antibiotics. Some physicians prefer to use allergy medications and decongestants in addition to antibiotics. In recent years, there are also physicians who use cortisone. However, it is necessary to be very careful when using cortisone in terms of possible side effects. cortisone e Although it causes the fluid in the middle ear to disappear in the early stages, the disease largely recurs in the long term. Surgery is considered in the presence of the following conditions:
– Middle ear fluids that persist for more than 3 months despite drug treatment
– Development of hearing loss of more than 30dB
– Collapse of the eardrum
The most common surgery for middle ear fluid collection is the removal of the adenoid and the insertion of a tube into the eardrum. Removing the adenoid eliminates the focus of infection. Additionally, the blockage effect on the Eustachian tube disappears. The ventilation tube attached to the eardrum helps ventilate the middle ear and thus middle ear gas pressures return to normal.
Is surgery the definitive solution?
The disease usually occurs after surgery to remove the adenoid and insert a tube into the eardrum. is greatly improved. The tube placed in the eardrum remains in place for 6-12 months and is usually removed spontaneously without the need for any other intervention. However, the patient must be followed for a while after the surgery. Especially in cases where the factors that predispose to the disease continue, fluid accumulation in the middle ear may occur again. However, as the child grows, the rate of recurrence of the disease decreases.
Unilateral fluid collection in the middle ear in an adult patient
This picture is a typical picture that can be seen in nasal tumors as well as in healthy people. For this reason, when an adult patient encounters fluid collection in the unilateral middle ear, nasal tumors must be excluded.
Read: 0
