上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin...
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上上上上上上上上上 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong university Otolaryngology institute at Shanghai jiaotong university
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Transcript of 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin...
上海市第六人民医院Shanghai Sixth People’s Hospital
Secretory otitis media
Shankai Yin Prof Dept of Otolaryngology, the sixth hospital
affiliated to Shanghai jiaotong university Otolaryngology institute at Shanghai
jiaotong university
上海市第六人民医院Shanghai Sixth People’s Hospital
Denomination
Otitis media with effusion Exudative otitis media Mucoid otitis media Catarrhal otitis media Tubotympanitis Non-suppurative otitis media………… Secretory otitis media
1991 我国自然科学名词审定委员会
上海市第六人民医院Shanghai Sixth People’s Hospital
Pathology
Middle ear effusionSerofluid 、 Mucus 、 Sero-mucous ， non blood
or CSF
Epithelium mucosae thicken ， Epithelial
metaplasiaPseudostratified columnar ciliated epithelium
Secretory epithelium
上海市第六人民医院Shanghai Sixth People’s Hospital
Epidemiology
Main in children 5.2-21.6% （ by aural speculum ， Hongkong ）， 7.3-30.7% （ by acoustic impedance ， Hongkong ） in 2-7 year-old
15-40% （ 2004 ， USA ） in 1-5 year-old 3.8% in 2 year-old ， 1.1% in 11 year-
old （ Suarez Nieto ， 1983 ， USA） More than 50% infant occurs ， most
natural cure in 3 months
上海市第六人民医院Shanghai Sixth People’s Hospital
Etiology
Eustachian tube dysfunction Eustachian tube blockage
Ciliary dysfunction
Infection
Immune reaction
上海市第六人民医院Shanghai Sixth People’s Hospital
Eustachian tube dysfunction
Disease in pharynx nasalis Adenoidal hypertrophy Nasopharyngeal carcinoma
Tumour from parapharyngeal space
上海市第六人民医院Shanghai Sixth People’s Hospital
Eustachian tube dysfunction
Circumflexus palati 、 levator palati weak
Cartilage of eustachian tube problem
上海市第六人民医院Shanghai Sixth People’s Hospital
Eustachian tube dysfunction
Rhinosinusitis Nasal polypus
上海市第六人民医院Shanghai Sixth People’s Hospital
Infection
Germ in excretion of mid ear （ Senturia ， 1958 ）
22-52% positive in excretion of mid ear
Hemophilies influenzae （ 14.7% ， USA ） and micrococcus pneumoniae （ 7.0% ， USA ） are the main pathogenic bacterium
Also influenzavirus 、 adenovirus 、 chalmdiae trachomatis
上海市第六人民医院Shanghai Sixth People’s Hospital
Immune reaction
Type I Allergic rhinitis
Nasal polyp
Bronchial asthma
Type III Bacterium in adenoid and pharynx oralis
上海市第六人民医院Shanghai Sixth People’s Hospital
Clinical manifestation
Common cold Hearing disturbance Earache Fural fullness Tinnitus
上海市第六人民医院Shanghai Sixth People’s Hospital
Objective sign
Deaphragma auris Hyperemia Invagination Mobility diminished
Cavum tympani Fluidify Air bubble
上海市第六人民医院Shanghai Sixth People’s Hospital
Objective sign
Pure tone test Conductive hearing loss
上海市第六人民医院Shanghai Sixth People’s Hospital
Objective sign
Combined deafness deafness Bacterium or toxin reach inner ear by RWM HC hurt
上海市第六人民医院Shanghai Sixth People’s Hospital
Objective sign
Acoustic impedance Type B ： typical plot Type C ： eustachian tube dysfunction
上海市第六人民医院Shanghai Sixth People’s Hospital
Differential diagnosis
Nasopharyngeal carcinoma Single secretory otitis media ， adult ，
lump in neck ， epistaxis Epipharyngoscope ， CT ， MRI
Cerebrospinal otorrhea Trauma or congenital deafness Temporal bone CT
上海市第六人民医院Shanghai Sixth People’s Hospital
Perilymphorrhea Stapes operation ， sudden deafness Tullio phenomenon
Cholesterol granuloma Sequela of secretory otitis media Dark blue eardrum Temporal bone CT
Differential diagnosis
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Spontaneous cure Etilogical treatment
Adenoidectomy Amygdalectomy FESS Explorative tympanotomy
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Drug treatment Antibiotic Glucocorticosteroid Decongestant Ambroxol
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Eustachian tube inflation
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Paracentesis tympani
Both diagnosis and treatment
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Paracentesis tympani Surface anesthesia Only adult Asepsis Complication
infection，impairment of RWMauditory ossicle fenestration oval window
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Myringotomy Cutter knife Carbon Dioxide laser
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Grommet insertion
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Grommet insertion Indication
inefficacy of myringotomyglue earhearing loss ： 40db
Complication Tympanosclerosis Permanence perforation of ear drum Chronic suppurative otitis media Sensorineural deafness
上海市第六人民医院Shanghai Sixth People’s Hospital
Thank you
