Your Audiology Tutorial: Serous Otitis Media

Here is an otoscopic view of a tympanic membrane (eardrum) that has been compromised by middle ear effusion, or fluid.  Common for an ear infection.  Air bubbles, as seen above, may be present.  The view often presents an intact TM, though with a cloudy or dull appearance.  Such a problem may be caused by blockage of the Eustachian tube, the pressure valve which runs from the nasopharynx to the middle ear space.  Obstruction may be caused by, among other things, enlarged and infected tonsils or adenoids.

Allergies and sinusitis can cause effusion, as can a viral infection.  In some cases, a tumor or neoplasm may be present.  A non-malignant (if rare) alternate cause may be a cholesterol granuloma, a cyst that forms in a part of the skull next to the middle ear.

Otitis media may be treated with oral antibiotics.  Other instances require pressure equalizing (PE) tubes, which are surgically placed into the TM to allow air in and release fluid into the throat.  This procedure is known as a myringotomy, usually performed in a ear, nose, and throat doctor's office, though sometimes in the OR.