Non-Suppurative Otitis Media

Introduction

• Non-suppurative otitis media is a part of inflammatory diseases of the middle ear.
• It contains two main types of diseases:
  • Secretory Otitis Media where there are fluids behind the eardrum.
  • Adhesive Otitis Media without clear fluids.

Secretory Otitis Media

• Known for the presence of fluids behind the eardrum.
• Appears under the name Otitis Media with Effusion (OME).
• Pathophysiology involves negative pressure leading to fluid leakage from surrounding tissues.
• Two types of mechanisms:
  • Transudation: Leakage of serous fluids without mucus.
  • Active Secretion: Active secretion of mucus due to cellular transformation in the mucosa.

Causative Factors

• Obstruction of the Eustachian tube causes negative pressure.
• Previous infections in the middle ear.
• Allergies and chronic sinusitis.
• Genetic factors and congenital abnormalities.

Adhesive Otitis Media

• Occurs as a result of previous or chronic secretory inflammation.
• Involves fibrosis of tissues inside the middle ear, impeding the natural movement of the auditory ossicles.

Symptoms

• Hearing loss.
• Tinnitus.
• Absence of pain or discharge.

Diagnostic Tests

• Hearing and middle ear function tests:
  • Pure Tone Audiometry: To determine the type and severity of hearing loss.
  • Tympanometry: To assess the movement of the eardrum.

Treatment

• Conservative treatment:
  • Use of medications such as mucolytics and corticosteroids.
  • Trying natural remedies like swallowing and chewing to open the Eustachian tube.
• Surgery:
  • Myringotomy and Ventilation Tube Insertion: Opening the eardrum and placing a ventilation tube to maintain internal pressure.

Prevention

• Early treatment of secretory otitis media to avoid progression to adhesive otitis.
• Use of hearing aids when needed.

Notes

• Rare diseases like otitis caused by tuberculosis or syphilis have not been detailed, as they are very rare.