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Middle Ear Inflammation (Serous Otitis) Causes and Treatment
October 28, 2023

Dr. ozbarsut

It can be defined as fluid accumulation in the middle ear. Generally, a middle ear infection can be the end of treatment in the following period or it can be seen without any ear complaints. In many patients, it is detected as a coincidence during routine examination.

CAUSES

The function of the Eustachian tube is to ventilate the middle ear by opening at certain intervals. When the canal is blocked for any reason that blocks the nasal passage, the air does not go to the middle ear and as soon as it exceeds 200 mm water pressure, fluid begins to leak from the mucosa and vessels lining the middle ear. The fluid is rich in protein in nature, so the possibility of infection is much higher than in a normal middle ear.

Many events affecting the area where the Eustachian tube is located are the cause of serous otitis. Adenoid, allergic rhinitis, sinusitis are the most important ones and these 3 factors are usually seen together.

TREATMENT

Diseases affecting the duct may need to be controlled and waited for 6-8 weeks.

PERSONAL EXPERIENCE

In serous otitis, the common ear is in the position of the victim of the event. I do not agree with the statements that we will put a tube in the ear in the first examination. I do not think that such a procedure will be beneficial without controlling diseases such as sinusitis allergic rhinitis that cause the disease.

Pediatric ENT examination is quite difficult compared to the adult.At least a few minutes of communication with the patient before the examination is necessary for a healthy examination.A good nasal examination as much as it can be done with a pediatric endoscope gives us very useful findings about sinusitis and allergy.Again, the 70-degree nasal area examination is done with a good communication with the family this time, which gives us the size of the adenoid and the nature of the nasal discharge, if any.If sinusitis and allergy are detected, treatment is given and 20 days later it is checked whether they have passed or not. If sinusitis and allergy are under control, the course of serous otitis is followed for 6-8 weeks. Measuring middle ear pressure at the beginning and at interim controls is useful both for follow-up and for the family’s belief in the treatment.

If the desired treatment success has not been achieved despite the adequate waiting period, we surgically remove the adenoid, if it has an effect on the disease, we surgically remove the tonsils and apply the paracentesis procedure in the ear. I explain that the procedures performed with good communication with the family before the operation will provide a great deal of treatment, it may be sufficient to remove the fluid in the ear, the child should be given a chance, if serous otitis recurs despite these procedures, we can insert a tube in a short time with mask anesthesia.The reason why I do not prefer the ear tube application is that Antalya is a city that has a lot of contact with water as a region. Especially in the summer months, the pool, the sea and the shower taken frequently due to the heat are indispensable for every child.tube insertion results in children being deprived of water.However, we know that especially the sea has many positive effects on diseases that predispose to ear problems such as sinusitis allergic rhinitis. Entering the sea, pool or even taking a shower with an ear tube is a torture for both the child and the family. No matter how much the ear is tried to be protected, the water that will escape from the outside will pass into the middle ear and ear discharge will be inevitable after a few hours.

CONCLUSION

In a child with fluid in the middle ear, sinusitis, if any, should be corrected first, allergy should be controlled and the response of the ear to treatment should be expected (6-8 weeks)

If success is not achieved, the adenoid should be removed and the process of removing the fluid from the ear, which we call paracentesis, should be applied.

If success is not achieved again, an ear ventilation tube should be inserted and followed up (in winter if possible).