Tuesday, March 23, 2021

FLUID IN THE MIDDLE EAR...... WHAT DOES IT MEAN ?

Sometimes fluid collection or effusion can occur in the middle ear ( back of the eardrum). It can lead to various problems.
 WHY DOES IT OCCUR ? 
Usually it occurs after an  upper respiratory infection like common cold. Can be seen in adults and children ( after an acute infection of the ear like acute otitis media, which will be explained later). Other causes of effusion are allergy like NASAL  ALLERGY leading to eustachian tube dysfunction, Barotrauma during flight especially take off and landing time. 
Eustachian tube obstruction  due to adenoid hypertrophy (enlargement) or a tumour like  skull base tumour ( meningioma) which occurs rarely and acid reflux can cause fluid in the middle ear. 
WHAT ARE THE SYMPTOMS OF EFFUSION ? 
The symptoms are hearing loss, ear fullness, tinnitus ( crackling sound) and sometimes imbalance. Sometimes history of smoking, ear infection, nose block,  nasal allergy will be there. IF ONLY ONE EAR IS INVOLVED IT HAS TO BE INVESTIGATED THOROUGHLY AS NASOPHARYNGEAL CANCER CAN CAUSE IT. 
In cancer other symptoms will be there. 
Ear findings in effusion can be present as  tympanic membrane bulge, retraction or as fluid. 
HOW IS IT TREATED  ? 
Patient has to be investigated and audiological test like tympanometry is one of them. Manoeuvres are there which helps in equalizing the middle ear pressure. Medical management includes treating nasal congestion and antiallergic treatment. 
Some patients ask me why they have to use nasal drops when their problem is inside the ear. This is one of such conditions where tube has to be opened in order to relieve the  fluid. 
Sometimes we have to do surgical treatment to let out the sticky glue like fluid from the middle ear. If fluid is present for a longer time it can lead to various problems like  conductive hearing loss. Balloon dilatation of eustachian tube ( ET) is done for recurrent problems. 
WHEN DOES IT RECUR  ? 
This condition occurs recurrently in those patients who have associated NASAL ALLERGY, ET   ABNORMALITIES, AND CHRONIC SINUSITIS. 
If this condition is not treated, it can lead on to  various complications like infection of the middle ear,  hearing problems , tympanic membrane atrophy, perforation and other serious conditions.
Effusion in children will be  explained  later


No comments:

Post a Comment

World Lung Day 2024

'Clean Air and Healthy Lungs for All ' is the theme for this year on World Lung Day which emphasizes the connection between air qual...