上海交通大学耳鼻咽喉科学英文版课件 secretory otitis media.ppt

* Secretory otitis media Denomination Otitis media with effusion Exudative otitis media Mucoid otitis media Catarrhal otitis media Tubotympanitis Non-suppurative otitis media Secretory otitis media(分泌性中耳炎) Pathology Middle ear effusion Serofluid、 Mucus、Sero-mucous，non blood or CSF Epithelium mucosae thicken，Epithelial metaplasia Pseudostratified columnar ciliated epithelium Secretory epithelium 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 Etiology Eustachian tube dysfunction Eustachian tube blockage Ciliary dysfunction Infection Immune reaction Eustachian tube dysfunction Disease in pharynx nasalis Adenoidal hypertrophy Nasopharyngeal carcinoma Tumour from parapharyngeal space  Cleft Palate Cartilage of eustachian tube problem Eustachian tube dysfunction Rhinosinusitis Nasal polypus Eustachian tube dysfunction Infection Germ in excretion of middle 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 Immune reaction Type I Allergic rhinitis Nasal polyp Bronchial asthma Type III Bacterium in adenoid and pharynx oralis Clinical manifestation Common cold Hearing disturbance Earache Aural fullness Tinnitus Objective sign Ear drum Hyperemia Mobility diminished Cavum tympani Fluid Air bubbles Pure tone test Conductive hearing loss  Objective sign Objective sign Combined deafness Bacterium or toxin reach inner ear by RWM HC hurt Objective sign Acoustic impedance Type B：typical plot Type C：eustachian tube dysfunction Differential diagnosis Nasopharyngeal carcinoma Unilatera