复旦大学：《耳鼻咽喉科学》课程教学资源（PPT课件讲稿，英文版）Otitis media with effusion

Otitis media with effusion Chunfu dai m,d&Ph D Otolaryngology Department Eye Ear Nose Throat Hos pital Fudan University

Otitis media with effusion Chunfu Dai M.D & Ph.D Otolaryngology Department Eye Ear Nose & Throat Hospital Fudan University

Background otitis media is a multifactorial disease process involving immunology, infectious disease, anatomic considerations, social and socioeconomic issues, and genetics, among other factors Approximately 70% of children below the age of 3 will develop an episode of otitis media

Background ◼ Otitis media is a multifactorial disease process involving immunology, infectious disease, anatomic considerations, social and socioeconomic issues, and genetics, among other factors. ◼ Approximately 70% of children below the age of 3 will develop an episode of otitis media

Background 65-95% of children by the age of 7 years will experience one or more episodes of acute otitis media It remains the commonest cause for visit to the doctor in the pediatric population

Background ◼ 65-95% of children by the age of 7 years will experience one or more episodes of acute otitis media. ◼ It remains the commonest cause for visit to the doctor in the pediatric population

Background Myringotomy was performed in eighteenth and nineteenth centuries to treat otitis media During the preantibiotic era, the primary concern was the potential for intracranial complications of acute otitis media In 1954, Armstrong ' s reintroduction of the tympanostomy tube, after that, few true advances in the treatment of otitis media was developed

Background ◼ Myringotomy was performed in eighteenth and nineteenth centuries to treat otitis media. ◼ During the preantibiotic era, the primary concern was the potential for intracranial complications of acute otitis media ◼ In 1954, Armstrong’s reintroduction of the tympanostomy tube, after that, few true advances in the treatment of otitis media was developed

Definition OME is an inflammatory condition of the middle ear and mastoid air cell system characterized by accumulation of fluid in the middle ear without signs or symptoms of acute infection

Definition ◼ OME is an inflammatory condition of the middle ear and mastoid air cell system characterized by accumulation of fluid in the middle ear without signs or symptoms of acute infection

Other names. u Secretory otitis media, Serous otitis media Glue ear Nonpurulent otitis media, Catarrhal otitis media

◼ Other names: ◼ Secretory otitis media, ◼ Serous otitis media, ◼ Glue ear, ◼ Nonpurulent otitis media, ◼ Catarrhal otitis media

Pathogenesis Dysfunction of Eustachian tube a obstruction of Eustachian tube Mechanic obstruction u enlarged adenoid tumor enlarged inferior turbinate Non mechanic obstruction a Weakness of related muscl Clearance and defense Immotile cilia syndrome 1. Eardrum rcutar canals B Vestibular nerve Note Eustachian tube

Pathogenesis ◼ Dysfunction of Eustachian tube ◼ Obstruction of Eustachian tube ◼ Mechanic obstruction ◼ enlarged adenoid, tumor, enlarged inferior turbinate ◼ Non mechanic obstruction ◼ Weakness of related muscle, ◼ Clearance and defense ◼ Immotile cilia syndrome

Pathogenesis Infection PCR detects the middle ear fluid, positive findings was 70% a S pneumonia, haemophalus influenzae, haemolytic streptococcus u Immunity Middle ear is a isolated immune system Inflammatory mediators Specific antibody immunologic complex Antigen may from adenoid or nasopharygeal lymph

Pathogenesis ◼ Infection ◼ PCR detects the middle ear fluid, positive findings was 70% ◼ S pneumonia, haemophalus influenzae, haemolytic streptocuccus ◼ Immunity ◼ Middle ear is a isolated immune system ◼ Inflammatory mediators ◼ Specific antibody, immunologic complex ◼ Antigen may from adenoid or nasopharygeal lymph

Classification of otitis media Otitis meda with effusion; the presence of middle ear effusion If the middle ear effusion is present for 8 Weeks or longer, it is classified chronic otitis media with effusion

Classification of Otitis media ◼ Otitis meda with effusion: the presence of middle ear effusion. ◼ If the middle ear effusion is present for 8 weeks or longer, it is classified chronic otitis media with effusion

Microbiology of otitis media Bacteria can be isolated from one third of patient who have OME The most common are s pneumonia, H influenzae and m catarrhalis (using traditional culture method) By using PCr these three bacteria were detected in approximately 70% of Chronic middle ear effusion

Microbiology of otitis media ◼ Bacteria can be isolated from one third of patient who have OME. The most common are S pneumonia, H influenzae, and M catarrhalis (using traditional culture method). ◼ By using PCR, these three bacteria were detected in approximately 70% of Chronic middle ear effusion