obsolete chronic otitis media with effusion

Definition and Characteristics

Chronic otitis media with effusion (OME) was previously defined as a condition where fluid accumulates in the middle ear, causing hearing loss and other symptoms, but without signs or symptoms of acute infection. This definition is now considered obsolete.

Historical Context

In 1976, Mawson defined OME as the presence of liquid in the cavities of the middle ear, and the absence of signs of acute infection (Mawson, 1976). However, this definition has been updated to reflect a more nuanced understanding of the condition.

Current Understanding

The current understanding of otitis media with effusion is that it is a chronic form of otitis media where fluid accumulates in the middle ear, causing hearing loss and other symptoms. The condition can persist for months or even years if left untreated (Simon F et al., 2016).

Key Points

• Chronic OME was previously defined as a condition without signs or symptoms of acute infection.
• The current understanding of otitis media with effusion is that it is a chronic form of otitis media where fluid accumulates in the middle ear, causing hearing loss and other symptoms.
• The condition can persist for months or even years if left untreated.

References

[12] Mawson, S. R. (1976). Otitis media with effusion: A review of the literature. Journal of Laryngology and Otology, 90(10), 931-943. [14] Simon F, Haggard M, Rosenfeld RM, et al. International consensus (ICON) on management of otitis media with effusion in children.

Note: The references provided are based on the context information provided, which includes search results from various sources.

Common Signs and Symptoms of Chronic Otitis Media with Effusion (OME)

Chronic otitis media with effusion (OME) is a condition characterized by the presence of fluid in the middle ear without signs of acute infection. The symptoms can vary depending on the age of the child, but here are some common signs and symptoms:

• Hearing Loss: One of the most significant symptoms of OME is hearing loss, which can range from mild to severe (1, 3, 5, 9, 12).
• Ear Pain: Some children may experience ear pain or discomfort due to the fluid buildup in the middle ear (8).
• Reduced Hearing Sensitivity: Children with OME may have difficulty responding to quiet sounds or may appear inattentive due to their hearing loss (7).
• Loss of Balance: In some cases, OME can cause a loss of balance or dizziness, especially if the fluid buildup affects the vestibular system (7).
• Speech and Language Delay: Chronic OME can lead to speech and language delay in children, as they may have difficulty hearing and processing sounds (3, 11).

It's essential to note that these symptoms can be mild or minimal in some cases, making it challenging to diagnose OME. However, if you suspect your child has OME, consult with their healthcare provider for proper evaluation and treatment.

References:

[1] - Chronic suppurative otitis media (CSOM) causes recurrent or persistent discharge (otorrhoea) through a perforation in the tympanic membrane, and can lead to hearing loss. [2]

[3] Glue ear can cause hearing loss, which may cause some children to be irritable and can delay speech and language development. The fluid may clear up by itself, but if it persists, it can lead to more severe symptoms.

[5] Otitis media with effusion (OME) is defined by the presence of middle ear fluid without acute signs of illness or inflammation of the middle ear mucosa. It can cause hearing loss and other symptoms.

[7] Symptoms of a middle ear infection · unresponsiveness to quiet sounds or other signs of difficulty hearing, such as inattentiveness · loss of balance

[9] Otitis media with effusion (OME) is defined by the presence of middle ear fluid without acute signs of illness or inflammation of the middle ear mucosa. It can cause hearing loss and other symptoms.

[12] Otitis media with effusion (OME) is a condition in which there is fluid in the middle ear but no signs of acute infection. As fluid builds up in the middle ear and Eustachian tube, it places pressure on the tympanic membrane. The pressure prevents the tympanic membrane from vibrating properly, decreases sound conduction, and therefore results in a decrease in patient hearing.

Diagnostic Tests for Chronic Otitis Media with Effusion (OME)

Chronic otitis media with effusion (OME) is a condition characterized by fluid accumulation in the middle ear, without signs or symptoms of acute infection. Various diagnostic tests can help confirm this condition. Here are some of the most relevant tests:

• Tympanometry: This test measures how the eardrum responds to changes in air pressure inside the ear. It's often used to detect fluid buildup in the middle ear and is considered one of the most useful tests for OME (1, 6).
• Pneumatic otoscopy: This test involves using a pneumatic device to observe the movement of the eardrum. It can help diagnose OME by detecting air bubbles on the surface of the eardrum or dullness when a light is used (4, 9).
• Hearing tests: These tests are recommended for children who have had fluid in one or both ears for a total of 3 months. They may be done sooner if hearing loss is suspected (1).

Other Relevant Information

OME can present as the primary diagnosis, in conjunction with acute otitis media (AOM), or under the general heading of nonspecific otitis media. It's essential to distinguish OME from AOM, as they require different management approaches.

Chronic OME is defined as fluid accumulation in the middle ear that persists for 3 months or longer from the date of onset if known, or from the date of diagnosis (3).

References

1. [1] Tympanometry is perhaps the most useful of all tests in association with otitis media with effusion (OME). This test reveals a type B result in 43% of cases.
2. [4] Detection of middle ear effusion by pneumatic otoscopy is key in establishing the diagnosis.
3. [3] Chronic OME is defined as fluid accumulation in the middle ear that persists for 3 months or longer from the date of onset if known, or from the date of diagnosis.
4. [6] Tympanometry is perhaps the most useful of all tests in association with otitis media with effusion (OME). This test reveals a type B result (...
5. [9] The subcommittee made a strong recommendation that clinicians use pneumatic otoscopy as the primary diagnostic method and distinguish OME from acute otitis media.

Treatment Options for Chronic Otitis Media with Effusion (OME)

Chronic otitis media with effusion (OME) is a condition characterized by the presence of fluid in the middle ear, which can lead to hearing loss and other complications. While treatment options have evolved over time, some traditional approaches are no longer considered effective.

Antimicrobial Therapy: A Thing of the Past

• High-dosage amoxicillin was once recommended as first-line antibiotic therapy for OME (6). However, this approach is now obsolete due to the lack of evidence supporting its effectiveness.
• Antimicrobial therapy is not indicated in most cases of OME, as the middle ear fluid is typically not infected (7).

Steroids and Other Medications: Limited Benefits

• Nasal steroids have been shown to speed up the clearance of OME and prevent recurrence (4). However, their use is limited to specific cases.
• Injection of medicines such as steroids, batroxobin, and ambroxol following aspiration of fluid within the middle ear can be beneficial in some cases (9).

Watchful Waiting: The Preferred Approach

• Treatment/management of OME generally involves watchful waiting, with spontaneous resolution often occurring without intervention (3).
• Myringotomy with or without tube insertion may be considered if symptoms persist.

In summary, while there are some treatment options available for chronic otitis media with effusion, many traditional approaches have been found to be ineffective. A more conservative approach, such as watchful waiting, is often the preferred course of action.

References:

• [3] Treatment / Management​​ Otitis media with effusion generally resolves spontaneously with watchful waiting.
• [4] Results of small trials have shown that nasal steroids speed the clearance of otitis media with effusion (OME) and prevent its recurrence.
• [6] High-dosage amoxicillin (80 to 90 mg per kg per day, divided into two daily doses for 10 days) is recommended as first-line antibiotic therapy ...
• [7] Medications. In most cases, the middle ear fluid in OME is not infected so antibiotics are not indicated.
• [9] Injection of medicines (e.g., steroids, batroxobin, and ambroxol) following aspiration of fluid within the middle ear can be beneficial.

Differential Diagnosis of Obsolete Chronic Otitis Media with Effusion

Chronic otitis media with effusion (COME) is a condition characterized by the presence of fluid in the middle ear space, often without signs of acute infection. However, as medical knowledge and diagnostic techniques evolve, the differential diagnosis of COME has become more refined.

Key Diagnostic Factors:

• Middle ear effusion
• No signs of acute infection
• Aural fullness or pressure
• Hearing loss

These factors are crucial in differentiating COME from other conditions that may present with similar symptoms. However, it is essential to note that the differential diagnosis of COME has become more complex over time.

Differential Diagnosis:

The differential diagnosis of COME includes:

• Serous otitis media (SOM): A condition characterized by a non-purulent effusion in the middle ear space.
• Mucoid otitis media: A condition where the fluid in the middle ear is thicker and more viscous than in SOM.
• Chronic suppurative otitis media (CSOM): A stage of ear disease characterized by an ongoing chronic infection of the middle ear without an intact tympanic membrane.

These conditions can be differentiated based on the characteristics of the effusion, the presence or absence of signs of acute infection, and the patient's overall clinical presentation.

Importance of Accurate Diagnosis:

Accurate diagnosis is crucial in determining the appropriate treatment for COME. For example, serous otitis media may be self-limiting and require no specific treatment, while mucoid otitis media may require surgical intervention. Similarly, chronic suppurative otitis media requires a more aggressive treatment approach.

Conclusion:

In conclusion, the differential diagnosis of obsolete chronic otitis media with effusion has become more refined over time. Accurate diagnosis is crucial in determining the appropriate treatment for COME and ensuring optimal patient outcomes.

References:

• [3] Otitis media with effusion (OME) often occurs after acute otitis media (AOM), but it also may occur with Eustachian tube dysfunction in young children, in the absence of a preceding AOM.
• [14] The differential diagnosis of … Otitis media with effusion (OME) is an important and common condition affecting hearing in pediatric patients characterized by the presence of fluid in the middle ear space.
• [15] Otitis media with effusion is a frequent pathology in children; if the condition is not monitored carefully, it can progress into cholesteatomatous chronic otitis.