الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
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SUMMARY
Otitis media with effusion is one of the commonest diseases of
children, the disease is clinically important becasue the variabale
conductive deafuess it produces during early school years which may
impair the child eductional progsess and because OME is widley
considered to be the percursor for all forms of chronic suppurative ear
disease in late life.
Many factors have been implicated in the pathogenesis of OME
but its precise cause remains obscure. The major underlying factors
responsible for the production of 01v1E are combination of eustachian
tube malfunction with superadded infection. Inadequancies of
mucociliary system can be condiered as a causative factor for OMB.
The enlargement of adenoids and/or tonsils was suggested as an
important cause of OME especially if associated with infection. Also
allergy being the causative factor for occurance of OME.
Most children with OME are asymptomatic, some may complain
of behavioral disorders, retardation of speech, language or educational
development due to hearing loss. However in older children the
presenting symptoms are conductive deafness and otalgia.
Otoscopy reveals loss of all or most of semitransparency and/or
retraction of tympanic membrane. pure tone aduiometry shows a
----- conductive hearing loss with air-bone gap probably between 20-30 dB.
Summary
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Tympanometry was found to be the most sensitive test to detect middle
ear effusion . Negative middle ear pressure of - 150 mm H20 or more
or flat tympanogram type B, should be cosidered pathalogical and
indicates OME. Absent stapedius reflex with flattened tympanogram is
taken to indicate middle ear effusion.
So combination of otoscopy, audiometry, tympanometry and
middle ear muscles reflex provides better senstivity and specificity than
does any other procedure alone.
ONtE is multifactorial disease so treatment should be directed
toward correction of offending factors such as infection, eustachian
tube dysfunction and allergy. Medical treatment should be tried before
surgical intervention. Medical therapy include antibiotics, decon
gestants, antihistamines corticosteroids, treatment of allergy and
immunziation. As yet, no satisfactory study has demonstrated any long
term benifit from large variety of medical treatment. And when. OME
persists longer than 3 monthes despite medical therapy, surgical
treatment should be considered.
Surgical treatment includes myringotomy with tympanostomy tube
insertion, adenoidectomy with or without tonsillectomy, mastoidectomy
and other procedures to control infection such as sinus drainage
procedures.
Summary
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Complications of tympanostomy tube are short term complications
as slippage, premature extrusion, granulation tissue formation,
occlusion, ear discharge and long term complications as, atrophic scar
formation, tympanosclerosis, microatelectasis, persisetant perforation
and rarely cholesteatoma formation.
In this study 50 patients with mean age of (+) 10.5 years suffering
£roms OME, (40 patients have bilateral OME and 10 patients have
unilateral ONE) were subjected to the following studies ;-
Careful history taking and full E.N.T examination and
tympanometry .
Eighty one (81) ears show type B tympanogram and (9) ears show
type C2 tympanogram and all ears had absent contralateral acoustic
reflex.
Pure tone audiometry showed air-bone gap 28.4dB. and all
patients had only tyrnpanostomy tube application. An immediate
audiometry and tympanometry were done after recovery from
anasethesia. The postoperative follow up in the form of clinical
examination and audiometric examination was done.
Summary
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In this study:-
- No cases of ossicular chain disruption were recorded.
- No cases of sensorineural hearing loss assaciated with tube
placement were recorded .
- 13.3% of ears showed no improvement in the air-bone gap
- The incidence of otorrhoea was 20%
• The incidence of extrusion was 21.12%
• The incidence of obstruction was 15.55%
- The incidence of permanent perforation was 5.2%
- No cases of cholesteatoma were recorded in this study.