الفهرس 
AnatomyOnly 14 pages are availabe for public view
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Abstract
l.
INTRODUCTION
otitis media ~lth effusion is one of tbe co~monest ch~onic
otol08 icalcoodit ions of childhood. The condition occurs in
ch i l dhood as overt or covert head ng loss presenting as all
edl,Jc••nQna,lor behavioral problem. In younger chf Id re n, if; may
present as speech snd language delay or 8S an a.rticulation defect.
Otten th,e bearing ~o:ss is first detected 00 routine screening
examinations before or at 3-5 years of age, Or later at a preschool
testing. Sometimes attention is drawn to it by frequent
episodes of ohlgia. [Ya,,_ 1987)
Al though oU tis lIIedia wi th cffus ion i is associated w:i.th a
conductive nearing loss. the degr,ee of this loss varies. and
effusion llIay be present in ma.ny patie.nts without significant
hearing loss. Tympanometry and determi.nation of the threshold of
the aCOUS tic ret Iex were rir s t· introduced :i n !965 as a c 1i n i ca I
tool to evalUate the middle ear function. Since then these methods
bave been widely used in diagnosis of various types of middle eat
patbology, specially otitis media with effusion. A negative midd.le
esr pressure of ISO mm”10 or ~ore Or a flat tympanogram should be
cons tde r ec pathological and an indication of otitis media”ith
eUus ion. IBtue s tone tit a1.. 1985]
2.
There is evidence that as high as 261 of patients .111 fail to
ijnpr ove ”i th medical treatment. TympaflostQlI)’with insertion of
tympanostomy tube is the most cnmmon sursieal procedure performed
tor chi 1dr en wi th pl!r-s is tent middle ear effus ion. (B,er-Illite in. t 985].