Journal Article

Brief Insight about Surgery in treatment of Otitis Media with Effusion

Ahmed Mohamed Anany, Ahmed Hassan Sweed, Mohammed Saleh, Ahmed Suliman, Ezzat Ahmed Merwad

2022

Overview

Dysfunction of ET and the gas exchange mechanism in the middle ear are important factors that affect the induction and persistence of OME.ET dysfunction induces hypoxic conditions in the middle ear of patients with OME. Additionally, in hypoxic conditions, hypoxia induces the expression of a group of physiologically important genes such as VEGF (vascular endothelial growth factor). Middle ear hypoxia resulting from ET obstruction and causing the release of hypoxia-induced factors and cytokines has been proposed as another mechanism of OME. Myringotomy for aspiration of serous or mucoid effusion can be made in a radial fashion, either in the anteroinferior or the anterosuperior quadrants, avoidingexcessive damage to the fibrous layer and thus preventing development of a thin triangular scar at the site of the incision. In chronic OME the myringotomy incision rapidely heals with reaccumulation of the fluid, and insertion of a VT facilitates longer lasting middle ear reventilation. Myringotomy and aspiration may be more areasonable treatment in adults who can undergo the procedure in the office. The benefit is that immediate improvement in hearing and symptoms of aural fullness and pressure are possible. The drawback is that the incision usually heals within 1 week, whereas the underlying problem of eustachian tube dysfunction takes longer to resolve (6 wk on average); therefore, recurrences are common. The position of hypertrophied adenoids may alter the final otologic outcome of patients requiring pressure equalization tubes insertion for OME. Patients withadenoids abutting the torus tubaris may benefit most from an adjuvant adenoidectomy. A strong recommendation that adenoidectomy should be performed unless when indication exists such as nasal obstruction or chronic adenoiditis

• Publisher: NeuroQuantology
• Subject: Gas exchange / Growth factors / Hypoxia / Insertion / Middle ear / Toruses / Tubes