Middle Ear Effusion

The definition of otitis media with effusion (OME) or, in other words, middle ear effusion, or “glue ear”, is a fluid and mucous accumulation in the middle ear without current infection. Usually, it is a dysfunction of the eustachian tube (ETT) which causes the above problem. For example, anatomical obstruction of nasopharynx caused by tumour, adenoid hyperplasia or peritubal tonsil enlargement can lead to a functional obstruction of the eustachian tube. The main symptoms are: a conductive type of hearing loss, autophony and popping or sloshing sound. On the other hand, it can be asymptomatic and found out during the patient’s visit because of other otolaryngological problems. The diagnosis is made otoscopically. The tympanic membrane often appears dull, yellowish or bluish without any signs of redness or perforation. We can see the cone of light dispersed and indistinct. In chronic OME cases the malleus (the ossicle in the middle ear) can retract the tympanic membrane. The malleus handle is horizontally aligned and its lateral process appears prominent. When untreated, the OME can lead to adhesive otitis and retraction pocket formation. In this video, we can see an effusion involving the right middle ear. Behind the tympanic membrane we can see yellowish fluid (not a pus) and bubbles –anterosuperiorly. During the Valsalva maneuver the bubblings or air are seen.