Adhesive Otitis Media - Endoscopic Examination

An endoscopic examination of the eardrum is shown in this video. The pars tensa of the eardrum seems to be atrophic (thinned-out and transparent), severely retracted and draped to the middle ear structures including the promontory, long process of incus, incudostapedial joint and the immediate head and lenticular process of stapes, the stapedius tendon, and the pyramid. It could be noticed the round and oval window impressions as well as its adjacent second part of facial nerve canal. However, there is no significant reduction of the hearing (of conductive type) due the effect called myringo-incudo-stapediopexy. This appearance should not be diagnosed as a large eardrum perforation. Adhesive otitis media is a several retraction of the eardrum which could be eventually plastered to middle ear structures or wall. This occurs after prolonged period of negative middle ear pressure usually as a complication of chronic eustachian tube dysfunction. Middle ear effusion (glue ear) can be present. The typical complications are retraction pocket and cholesteatoma formation. Treatment is performed to eliminate the source of the disease and to normalize the middle ear pressure (by the insertion of grommet) with the hope of regaining the eustachian tube function.