外语渗出性中耳炎概念.ppt

OTITIS MEDIA WITH  EFFUSION ----(OME) 一、overview Otitis media with effusion (OME) is characterized by accumulation of fluid in the middle ear, conductive hearing loss , and is a kind of non-purulent diseases of middle ear. 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 . Function of the eustachian tube The eustachian tube is essential in maintaining a healthy, well-aerated the middle ear. 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 Any process that interferes with normal opening of proximal ( nasopharyngeal ) end of the eustachian tube or mucociliary clearance mechanism causes OME (1)、mechanical obstruction: large or infected adenoids turbinate hypertrophy neoplasm of nasopharynx nasopharyngeal edema or inflammation (2).Allergy Allergy reaction affects both mucociliary clearance mechanism and normal eustachian tube opening. (3).Abnormal eustachian tube  anatomy Such as: cleft palate deformities can impair eustachian tube function. Functional disorders of eustachian tube→negative pressure in tympanic cavity →veins in mucous be dilated and be congested → vessels permeanc