What is OME?
OME is the most common cause of audition impairment in children. OME is the collection of fluid in tympanic cavity while the eardrum is preserved. The exudative fluid, if lying behind for a long time, can sometimes thicken as a jelly. It can cause intramembranous adhesions immobilising the chain of auditory ossicles and languid destroying of eardrum. It presents with hypoacusia, which, if untreated, can lead to speaking impairment and have disadvantageous influence on child’s psychosocial development. In more than half cases, this chronic inflammatory state is preceded by episodes of acute otitis media with recurring upper respiratory infections (URIs). One of the most common causes of this disease is the abnormal patency of Eustachian tube related to pharyngeal tonsil hypertrophy. The list of risk factors includes artificial feeding in infancy, parents’ smoking, attending nursesy which results in more frequent exposition to URIs, immunity disorders, allergy, and esophagopharyngeal reflux.
OME symptoms:
Originally, this disease can be asymptomatic. The collection of exudate leads to hearing impairment. Speaking disorders, delayed speaking development and mild balance disorder can be observed in younger children. In case of older children, it can lead to attention disorders, learning problems and difficulties in peer relationships.
Diagnosis
It is based on analysis of medical history, otoscopic examination of the ear, where the presence of the exudative fluid behind the preserved eardrum is confirmed, and also the acumetry – impedance audiometry, and with older children also the tonal audiometry.
Treatment
In more than 80% of children, the exudates (if treated) relents idiopathically in 3 to 6 months. In case of the lack of improvement, a surgery is performed – tympanopunction with presumptive air drainage of tympanic cavities under general anaesthesia.
Tympanopunction involves punctuation of the eardrum in order to remove the exudative fluid lying behind in tympanic cavities. Sometimes an incision of eardrum (so-called paracentesis) is performed. The aperture closes within few hours (after tympanopunction) up to a fortnight (after paracentesis).
In order to rectify the effect of auditional improvement and ensure airing of tympanic cavity, a tiny airing drain, shaped as a bobbin, is established in the eardrum. This drain is placed in the eardrum in such a way that one of the collars is placed under the eardrum, and the second one – over the eardrum.
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