scholarly journals Pathogenesis of Secretory Otitis Media

2015 ◽  
Vol 4 (1) ◽  
pp. 10-15
Author(s):  
Chao Wen ◽  
Xiaoyu Wang ◽  
Taisheng Chen ◽  
Hongying Ruan ◽  
Peng Lin
Keyword(s):  
Immune Response ◽  
Hearing Loss ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Hot Spot ◽  
Mechanical Obstruction ◽  
Secretory Otitis Media

Abstract Secretory otitis media (SOM) is a common and frequently occurring disease featured by middle ear cavity exudant, ear nausea, and hearing loss. Morbidity of children is higher than that of adults. The pathogenesis and etiology of SOM are clear so far. Previous reports concluded that the mechanical obstruction and dysfunction of the eustachian tube are among the important causes of infection. The mechanism of infection and immune response in the pathogenesis of SOM is currently becoming a research hot spot, providing a reference for further study.

Impedance Audiometry Suggested

PEDIATRICS ◽  
1974 ◽  
Vol 54 (3) ◽  
pp. 384-384
Author(s):  
John A. McCurdy
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Otitis Media ◽  
Middle Ear ◽  
Verbal Ability ◽  
Secretory Otitis Media ◽  
Suppurative Otitis Media ◽  
Significant Percentage ◽  
Children With Hearing Loss ◽  
Verbal Development

The findings of Kaplan et al.1 with respect to impairment of verbal ability in Alaskan children with hearing loss greater than 25 dB ISO secondary to chronic suppurative otitis media warrant renewed attention to a similar otologic problem which constitutes a threat to the verbal development of a significant percentage of all children—hearing impairment secondary to chronic secretory otitis media. Although the hearing loss in chronic secretory otitis media may fluctuate, a significant conductive impairment will persist as long as fluid remains in the middle ear.

Patent Eustachian Tube in the Underaerated Middle Ear: A Paradox

1988 ◽  
Vol 97 (3) ◽  
pp. 219-221 ◽  
Author(s):  
Richard A. Buckingham
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Essential Factor ◽  
Secretory Otitis Media ◽  
Ear Diseases ◽  
Tube Obstruction ◽  
Middle Ear Pressure

Secretory otitis media, middle ear atelectasis, and retraction type cholesteatomas are the most frequently occurring chronic middle ear diseases; and eustachian tube obstruction and the generation of negative or less than atmospheric middle ear pressure is said to be an essential factor in the pathogenesis of these diseases. It has been found that habitual sniffing causes high degrees of negative middle ear pressure in diseased ears; this finding demonstrates eustachian tube patency rather than obstruction. Ears intubated for chronic secretory otitis media, middle ear atelectasis, and cholesteatoma were examined to identify patent eustachian tubes. More than one third of the patients aspirated a solution into the middle ear with one or more sniffs by aspirating air from their middle ears, demonstrating eustachian tube patency rather than obstruction.

Chronic Secretory Otitis Media: Effects of Surgical Management

1989 ◽  
Vol 98 (1_suppl2) ◽  
pp. 2-32 ◽  
Author(s):  
George A. Gates ◽  
J. C. Cooper ◽  
Christine A. Avery ◽  
Thomas J. Prihoda
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Surgical Management ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Secretory Otitis Media ◽  
Tympanostomy Tubes ◽  
The Mean ◽  
First Recurrence

To study the effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion, we randomly assigned 578 4- to 8-year-old children to receive one of the following: Bilateral myringotomy and no additional treatment (group 1), tympanostomy tubes (group 2), adenoidectomy and myringotomy (group 3), or adenoidectomy and tympanostomy tubes (group 4). The 491 who accepted surgical treatment were evaluated at 6-week intervals for up to 2 years. Treatment effect was assessed by four main outcomes: Time with effusion, time with hearing loss, time to first recurrence of effusion, and number of surgical re-treatments. For the groups (in order), the mean percent of time with any effusion in either ear was 49, 35, 30, 26 (p < .0001); the mean percent of time with hearing thresholds 20 dB or greater was 19, 10, 8, and 7 (p < .0001) in the better ear; and 38, 30, 22 and 22 in the worse ear (p < .0001); the median number of days to first recurrence was 54, 222, 92, and 240 (p < .0001); and the number of surgical re-treatments was 66, 36, 17, and 17 (p < .0001). The most notable adverse sequela, purulent otorrhea, occurred in 22%, 29%, 11%, and 24% of the patients assigned to groups 1 through 4, respectively (p < .001). In severely affected children who have chronic otitis media with effusion resistant to medical therapy, adenoidectomy is an effective treatment. Adenoidectomy plus bilateral myringotomy lowered posttreatment morbidity more than tympanostomy tubes alone and to the same degree as did adenoidectomy and tympanostomy tubes. Adenoidectomy appears to modify the underlying pathophysiology of chronic otitis media with effusion. This effect is independent of the preoperative size of the adenoid. Tympanostomy tube drainage and ventilation of the middle ear provide adequate palliation so long as the tubes remain in place and functioning. We recommend that adenoidectomy be considered in the initial surgical management of 4- to 8-year-old children with hearing loss due to chronic secretory otitis media that is refractory to medical management and, further, that the size of the adenoid not be used as a criterion for adenoidectomy. Concomitant bilateral myringotomy with suction aspiration of the middle ear contents also should be done, with or without placement of tympanostomy tubes at the discretion of the surgeon.

Eustachian Tube Lumen: Comparison between Normal and Inflamed Specimens

1989 ◽  
Vol 98 (8) ◽  
pp. 630-634 ◽  
Author(s):  
Jacob Sadé ◽  
Michal Luntz
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Sectional Area ◽  
Secretory Otitis Media ◽  
Cross Sectional ◽  
Tube Lumen ◽  
Luminal Area ◽  
The Mean ◽  
Temporal Bones

This study presents measurements of the cross-sectional luminal area of the eustachian tube. Comparisons are made between the lumens of eustachian tubes obtained from temporal bones presenting acute or secretory otitis media and those from noninflamed temporal bones. The material consisted of 71 temporal bones obtained postmortem from individuals up to 2 years of age. Forty-six of these showed no middle ear inflammation, while 25 presented either acute or secretory otitis media. In both groups the lumens of all the eustachian tubes were patent, presenting no obstruction. The mean cross-sectional area of the lumens of inflamed temporal bones was smaller than that of the noninflamed ones. This difference was not found to be statistically significant in the cartilaginous regions and was found to be statistically significant or borderline significant in the bony parts of the eustachian tube.

Middle Ear Ventilation in Secretory Otitis Media

1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 178-181 ◽  
Author(s):  
Jörgen Holmquist ◽  
Ulf Renvall
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Cell System ◽  
Eustachian Tube Function ◽  
Secretory Otitis Media ◽  
Pressure Equalization ◽  
Middle Ear Ventilation ◽  
Tube Function ◽  
Equalization Technique

The Eustachian tube function was determined repeatedly in 42 patients during as well as after the course of secretory otitis media. Air pressure equalization technique and impedance audiometry were used. Also the size of the mastoid air cell system was determined. It was found that poor tubal function and a small mastoid air cell system are significant findings in these ears.

The nasopharynx, eustachian tube and otitis media

1994 ◽  
Vol 108 (2) ◽  
pp. 95-100 ◽  
Author(s):  
Jacob Sadé
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Negative Pressure ◽  
Secretory Otitis Media ◽  
Ascending Infection ◽  
Middle Ear Infection ◽  
Nasopharyngeal Mass ◽  
Flow Through ◽  
Ear Effusion

AbstractIt has been classically hypothesized that a mass in the nasopharynx causes an obstacle to air flow through the eustachian tube, thereby creating a negative pressure in the middle ear followed by an effusion. However, examination of the relevant data concerning the supposed obstruction of the eustachian tube by nasopharyngeal carcinomas, choanal polyps and adenoids does not seem to support this cause and effect relationship. Evidence points to other more sophisticated mechanisms which cause negative pressure and an effusion in pathological middle ear conditions. While the hypothesis of a nasopharyngeal mass as the usual obstructive cause of middle ear effusion is hard to maintain, evidence does exist to support the origin of middle ear infection, as seen in acute and secretory otitis media, as being associated, at times, with an ascending infection from the nasopharynx.

Concepts on the Pathogenesis of Middle Ear Effusions

1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 182-186 ◽  
Author(s):  
Charles D. Bluestone ◽  
Quinter C. Beery
Keyword(s):  
Fluid Flow ◽  
Pressure Gradient ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Active Muscle ◽  
Secretory Otitis Media ◽  
Tube Obstruction ◽  
Narrow Neck

Several concepts related to the pathogenesis of middle ear effusions are postulated. The mechanisms proposed are based on an understanding of fluid mechanics. A flask with a long, narrow neck is presented as a model of the Eustachian tube-middle ear-mastoid system. Fluid flow into and out of the flask is dependent upon the pressure gradient, compliance of the narrow neck and whether or not the bulbous portion is intact. It is suggested that locking of the tube may be dependent upon the speed of the application of the negative pressure and the compliance. Eustachian tube opening appears to be related not only to active muscle forces but may also be dependent upon the presence of a pressure gradient which passively assists tubal function. It is proposed that middle ear effusions result from reflux, aspiration or insufflation of nasopharyngeal secretions (acute otitis media), or from persistent functional or mechanical Eustachian tube obstruction (secretory otitis media) or both.

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