外语课件 渗出性中耳炎.ppt

OTITIS MEDIA WITH  EFFUSION ----(OME);一、overview;OME occurs as a result of decreased ventilation of the middle ear or mastoid air-cell system through the eustachian tube .; Serous Otitis Media Glue Ear Non-purulent Otitis Media ; OME is one of the most commonly resulting in deafness among children. OME occurs in adult too .;;7;Function of the eustachian tube;9; The eustachian tube ventilates the middle ear, protects it from pathogenic organisms in the nasopharynx, equilibrates pressure across the tympanic membrane, and allows drainage of secretions from the middle ear into nasopharynx.; At rest , the eustachian tube is closed. During swallowing, yawning, or sneezing, the nasopharyngeal orifice of eustachian tube is opened transiently. ;The anatomy of the eustachian tube of infants is different from adult’s . The infantile eustachian tube is more horizontal orientation, shorter length, and more patulous configuration than adult.;二、Pathogenesis;(1)、mechanical obstruction:;(2).Allergy;(3).Abnormal eustachian tube  anatomy; Functional disorders of eustachian tube→negative pressure in tympanic cavity →veins in mucous be dilated and be congested → vessels permeance be increased →serum in vessels be exuded into tympanic cavity→ middle ear effusion  ;三.Clinical Presentation;Physical Examination;20;21;22; Audiometric Testing ;Audiogram; Acoustic Immittance; Normal acoustic immittance is “type_A” curve. The curve has peak at “O” Pascal pressure point. OME’s Acoustic immittance is “type_B” curve. It is flat tympanometric curve ;四、 Diagnosis;（二）、Clinical presentation :;(三)、Physical examination;（四）、Audiometric Testing;　1、tympanosclerosis2、glomus jugulare tumor 3、cerebrospinal otorrhea ４、nasopharyngeal carcinoma;六、 Management　; (1)、Keep expedite nasal cavity  and eustachain tube;(2)、Eustachian tube insuffl