adhesive otitis media

Adhesive otitis media, also known as glue ear, is a condition where a thin, retracted eardrum becomes stuck to the ossicles and other bones in the middle ear. This results in the fluid buildup in the middle ear, causing pressure on the tympanic membrane, reducing sound conduction, and difficulty in hearing.

The main manifestation of adhesive otitis media is progressive hearing loss, impaired perception of sounds of a certain wavelength, and the appearance of symptoms such as ear pressure or discomfort, or ear blockage without symptoms of acute infection [5][9].

Adhesive otitis media occurs when a thin retracted ear drum becomes sucked into the middle-ear space and stuck [3][4]. This condition is often associated with untreated middle ear effusion caused by long-term eustachian tube dysfunction (ETD) [6].

The symptoms of adhesive otitis media can vary, but common signs include difficulty hearing, swelling in ears due to fluid buildup in the middle ear, and impaired balance or poor school performance in children [2][14]. In some cases, the condition may lead to more severe complications such as formation of a cholesteatoma or fixation and erosion of the ossicles [15].

Adhesive otitis media is often considered a sequela of neglected otitis media with effusion (OME) from long-standing Eustachian tube dysfunction and the subsequent chronic OME [13]. The condition can be diagnosed through an examination, which should include an evaluation and description of the tympanic membrane characteristics such as color, position, depth, whether it is fixed or mobile, the presence of discharge, the accumulation of keratin, and the presence of bony erosion [12].

It's worth noting that adhesive otitis media can be a complication of untreated middle ear effusion caused by long-term eustachian tube dysfunction (ETD), and its treatment may involve addressing the underlying cause of the condition.

Adhesive otitis media, also known as glue ear, is a condition characterized by fluid buildup in the middle ear without signs of acute infection. The most common symptoms of this condition include:

• Hearing loss: This is often the primary symptom of adhesive otitis media, and it can affect one or both ears.
• Ear pressure or discomfort: Some people may experience a feeling of fullness or pressure in their ears due to the fluid buildup.
• Ear blockage: The fluid in the middle ear can cause a sensation of blockage or congestion in the ear.

In children, symptoms attributable to adhesive otitis media may also include:

• Poor balance
• Poor school performance
• Behavioral problems

It's worth noting that some people with adhesive otitis media may not experience any noticeable symptoms at all. However, if left untreated, this condition can lead to long-term hearing loss and other complications.

According to [7], OME (otitis media with effusion), previously termed serous otitis or glue ear, is fluid in the middle ear without signs and symptoms of infection, other than transient hearing impairment. This suggests that adhesive otitis media is a type of chronic otitis media characterized by fluid buildup in the middle ear.

The medical term for glue ear is otitis media with effusion (OME) [9]. The most common sign of glue ear is hearing loss, which can affect one or both ears. If your child's healthcare provider suspects adhesive otitis media, they may perform a physical exam and an ear exam to confirm the diagnosis.

References: [7] by MRCH Portal [9] The medical term for glue ear is otitis media with effusion (OME).

Adhesive otitis media, also known as glue ear or otitis media with effusion (OME), can be diagnosed through various tests. Here are some diagnostic tests used to identify this condition:

• Pneumatic otoscopy: This is a useful technique for diagnosing adhesive otitis media, with a sensitivity and specificity of 70-90% [2]. Pneumatic otoscopy involves using a pneumatic device to examine the eardrum and middle ear.
• Tympanometry: Tympanometry is perhaps the most useful test in association with OME, revealing a type B result in 43% of cases [4, 9]. This test measures how the eardrum responds to changes in air pressure inside the ear.
• CT or MRI scans: These imaging studies can be used to visualize the middle ear and determine the degree of adhesions and severity of adhesive otitis media [5].
• Otoscopy: Observing the bulging of the tympanic membrane is the best way to determine the type of otitis media [6].

It's worth noting that a combination of these tests may be used to confirm the diagnosis of adhesive otitis media.

References:

[2] - Pneumatic otoscopy is 70-90% sensitive and specific for determining the presence of AOM and OME (search result 2) [4, 9] - Tympanometry reveals a type B result in 43% of cases associated with OME (search results 4 and 9)

Adhesive otitis media (AdOM) is a complication of untreated middle ear effusion caused by long-term eustachian tube dysfunction (ETD). According to the medical literature, there are limited treatment options for AdOM, and most cases resolve on their own with proper monitoring.

However, if the condition persists, myringotomy with tympanostomy tube insertion is an effective treatment. This procedure involves inserting a ventilation tube into the middle ear to allow air entry and prevent the re-accumulation of fluid [14].

As for drug treatment, there are no specific medications that target AdOM directly. However, antibiotics may be prescribed in cases where there is a secondary bacterial infection [8]. It's worth noting that routine use of antibiotic treatment for acute otitis media is generally avoided due to concerns about antibiotic resistance and other complications [9].

In terms of pharmacologic management, antimicrobial agents, steroids, antihistamines, and decongestants may be used in the treatment of otitis media with effusion (OME), which can sometimes lead to AdOM. However, these treatments are not specifically targeted at AdOM and should be used under the guidance of a healthcare professional [6].

It's also worth noting that high-dose amoxicillin is often recommended as the first choice for initial antibiotic therapy in children with acute otitis media (AOM), which can sometimes lead to AdOM [4]. However, this treatment approach may not be directly applicable to AdOM.

In summary, while there are no specific drug treatments for adhesive otitis media, myringotomy with tympanostomy tube insertion is an effective surgical treatment option. Antibiotics may be prescribed in cases of secondary bacterial infection, but routine use should be avoided due to concerns about antibiotic resistance and other complications.

Differential Diagnoses of Adhesive Otitis Media

Adhesive otitis media, also known as chronic otitis media or otitis media with effusion, is a condition characterized by fluid buildup in the middle ear. The differential diagnoses for this condition include:

• Acute Otitis Media: A bacterial infection of the middle ear that can cause symptoms such as fever, ear pain, and hearing loss.
• Nasopharyngeal Carcinoma Infiltrating the Eustachian Tube: A type of cancer that can spread to the eustachian tube and cause blockage, leading to fluid buildup in the middle ear.

According to search result [2], adhesive otitis media is a form of chronic otitis media or otitis media with effusion caused due to fluid buildup in the middle ear. This condition can be distinguished from acute otitis media by its chronic nature and the presence of fluid in the middle ear.

Other conditions that may present similarly to adhesive otitis media include:

• Glue Ear (Otitis Media with Effusion): A condition characterized by fluid buildup in the middle ear, leading to hearing loss.
• Glandular Metaplasia: A condition where gland-like structures form in the middle ear, which can be a differential diagnosis for adhesive otitis media.

It's essential to note that accurate diagnosis of adhesive otis media requires a thorough examination and medical history. The presence of fluid in the middle ear, along with symptoms such as hearing loss and ear fullness, can help differentiate this condition from other ear-related issues.

References:

• [2] - Adhesive otitis media is caused due to fluid buildup in the middle ear.
• [8] - Glandular metaplasia seen in otitis media includes MEA (Middle Ear Adhesive).
• [10] - Otitis Media Differential Diagnoses.