OTITIS MEDIA WITH EFUSION

The most common form of expression of this most common childhood disease among the public fluid collection in the middle ear is ”. Fluid accumulation in the middle ear in childhood is the most common condition in the ENT literature. SOLID( serous otitis media), but in the most correct way EOM( otitis media with effusion ) is called. EOM definitive treatment It is a possible disease. In a significant proportion of children, the disease can even resolve spontaneously. If there is no improvement within a month medicine treatments can be tried. In stubborn cases surgicaldefinitive treatment can be made.

kulak anatomi

THE STRUCTURE OF THE MIDDLE EAR

The eardrum is located at the end of the external auditory canal. The anterior surface of the membrane is adjacent to the external auditory canal and the posterior part is adjacent to the middle ear cavity. Sound waves hitting the membrane reach the inner ear by vibrating the hammer bone, which is connected to the membrane, and then the anvil and stirrup, respectively. These hammer, anvil, and stirrup bones in the middle ear are known as the ossicular chain. In order for sound energy to reach the inner ear in the most ideal way, it needs a solid and freely vibrating eardrum and ossicular chain. In order for the eardrum and osseous chain system to vibrate comfortably, both sides of the eardrum must be filled with air at equal pressure. The outer side of the eardrum is directly open to the atmosphere through the outer ear and is under the influence of 1 atmosphere of air pressure. The air of the middle ear cavity behind the membrane comes from the nasal cavity. Eustachi pipecomes through.

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Nasal occlusion

The nasal region is located at the back of the nasal cavity, in the upper part of the soft palate and uvula. During breathing, the air passing through the nose reaches the larynx by passing through the nasal cavity. During the development of a healthy child, from an early age in the nasal region adenoid tissue( adenoid ) begins to grow. If a mass occupying space is found in the nasal region, nasal congestion occurs and the mouth is used to breathe. If dysfunction occurs in the Eustachi tube due to adenoid, air delivery to the middle ear is disrupted.

efuzyonlu otitis media

LIQUID COLLECTION IN THE MIDDLE EAR

If the Eustachi tube does not work, the air pressure in the middle ear drops and a vacuum effect occurs. In other words, the air pressure in the outer ear remains relatively high, and the eardrum begins to collapse towards the middle ear with the effect of positive pressure. If this situation lasts for a long time, secretion is produced by the middle ear cover. As a result, the middle ear cavity is filled with fluid and the eardrum is supported from the inside.

If the Eustachian tube dysfunction resolves within a few weeks, the secretions will discharge into the nasal cavity and everything will return to normal. However, if the obstruction lasts longer, the secretions gradually thicken and reach the consistency of glue, preventing the membrane and ossicles from vibrating, and causing moderate hearing loss. If the problem persists for months, it can cause adhesions in the middle ear and permanent problems extending into adult life.

MEDICAL TREATMENT OF DISEASE

In the follow-up of OME, improvement can sometimes occur even without medication. If the complaints do not improve within a few weeks in a newly diagnosed case, middle ear pressure should be measured and treatment with various drugs should be tried. If the patient’s history and examination and examination results suggest that there is a long-term problem, the treatment option should be surgery before it is too late.

SURGICAL TREATMENT OF THE DISEASE

In surgery, the eardrum is punctured and the fluid is drained, and a tube must be placed to help carry air into the middle ear so that the created hole does not close immediately. If the adenoid is thought to be the cause of the pathology, the adenoid should also be surgically removed.

POSTOPERATIVE FOLLOW-UP

By inserting a tube into the eardrum, the integrity of the membrane is disrupted. In this case, if water gets into the outer ear canal, it is possible for the water to pass into the middle ear and may cause inflammation in the middle ear. Water should be prevented from escaping with earplugs, the head should not be put into the water while swimming in the pool or the sea. Tubes should be monitored every 2-3 months. As our body throws away all foreign substances in its body, it will usually throw out the tubes. If the tubes are discarded before the event that prevents the aeration of the Eustachi tube in your nasal passage is resolved, it may need to be reinserted. In patients with prolonged nasal obstruction, special tubes that can remain for a long time can be inserted. In general, tubes are not allowed to remain for more than 2 years. Tubes that remain for a long time or tubes that cause inflammation in the middle ear can be removed during the ENT examination.

REMEMBER

OME is the most common childhood disease.

– Usually the cause is the enlargement of the adenoid.

– It is possible to treat this disease.

– Even if the adenoid is removed, it can grow again depending on the age and physiology of the child, and if it causes dysfunction, it may need to be taken again.

– Water should not be leaked into the ears with a tube.

– It is important to follow the ear tubes.

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