What is eustachitis

Acute serous otitis media

Synonym: acute tube middle ear catarrh
English: obstruction of the auditory tube, eustachitis

1 definition

The acute serous otitis media refers to an inflammation of the middle ear caused by swelling of the mucous membrane and closure of the lumen of the auditory tuba

ICD10 code: H65.0

2 etiopathogenesis

The swelling of the tube mucosa leads to insufficient ventilation of the tympanic cavity. In this air is then absorbed, which leads to a negative pressure in the middle ear with retraction of the eardrum.

This can lead to exudate in the tympanic cavity.

The swelling of the tube mucosa is often caused by catarrhal diseases in the area of ​​the nasopharynx, which impair nasal breathing. However, a septum deviation, turbinate swelling, enlarged tonsils or a tumor in the nasopharynx can impair nasal breathing and thus lead to catarrh of the middle ear.

3 clinic

Patients complain of a feeling of pressure in their ears and deterioration in hearing. Noise may also develop in the ear.

4 complications

With inadequate treatment, seromucotympanum can develop. There is thus a risk of transition to chronic serous otitis media. Due to the negative pressure in the tympanic cavity, there is also the risk of rupturing the membrane of the round window (fenestra rotunda).

5 diagnostics

The otoscopy shows a retraction of the eardrum: the short extension of the hammer jumps forward, the hammer grip appears to be shortened. This leads to the formation of a posterior fold of the eardrum. The light reflex has moved away from the umbo. The eardrum is pink in color, but not reddened or bulging. If an effusion has formed, it will shine through the eardrum and reveal a level of fluid that changes as the head moves.

The tube function test according to the Politzer method shows liquid bubbles.

In the Weber experiment, a tube middle ear catarrh is lateralized into the affected ear. Conductive hearing loss can be seen in the audiogram. In the tympanogram, the peak is shifted to the left.

6 therapy

Therapy is based on restoring normal breathing through the nose. This can be done, for example, with decongestant nasal drops or an operation (depending on the cause, e.g. adenotomy, septoplasty).

Tubes can also be blown through, although this should not be carried out in the case of acute rhinitis, as otherwise viruses and bacteria will be blown into the middle ear and cause acute otitis media there.

If an exudate has developed, heat radiation can promote resorption. There is also the possibility of paracentesis and suction of the exudate as well as the transtympanic puncture of the tympanic cavity.