By Cuneyt Alper MD, Charles Bluestone MD, Margaretha Casselbrant, Joseph Dohar MD, Ellen Mandel MD
Complex treatment of Otitis Media offers solutions to medical care questions from the most typical difficulties to infrequent issues and sequelae of otitis media. The publication pursuits clinicians who look after sufferers with various otolaryngological displays on a daily basis. every one bankruptcy within the booklet specializes in an method of a selected medical subject; diagnostic strategy; healing process; problem comparable query; or controversy. The chapters describe the topic, occurrence, value, etiology/pathogenesis, and administration thoughts.
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Extra resources for Advanced Therapy of Otitis Media
I = incus; L = lateral process of malleus; P = light reflex from promontory; U = umbo. 14 Examination of the Tympanic Membrane for Otitis Media / 15 FIGURE 3-2. When both the ear canal and middle ear are at atmospheric pressure, the eardrum assumes its natural configuration, which is doubly curved or “seagull” shaped. The arrow indicates incident light from the otoscope and the position of light reflex. of the ear canal, the light reflex appears not at the center of the eardrum but on the outward curve of the eardrum in the anteroinferior quadrant (see Figures 3-1 and 3-2).
In noncooperative children, pneumatic otoscopy is the examination of choice. Diagnostic Methods / 13 References Arola M, Ruuskanen O, Ziegler T, et al. Clinical role of respiratory virus infection in acute otitis media. Pediatrics 1990;86:848–55. Barnett ED, Klein JO, Hawkins KA, et al. Comparison of spectral gradient acoustic reflectometry and other diagnostic techniques for detection of middle ear effusion in children with middle ear disease. Pediatr Infect Dis J 1998;17:556–9. Block SL, Pichichero ME, McLinn S, et al.
An otoscope can easily be carried and provides a good and quick visualization of the TM and its mobility. However, an otomicroscope may be superior when suctioning MEE through a tympanostomy tube, when examining granulations or other changes of a TM, and in some cases of cerumen removal. Diagnostic Methods / 11 Tympanometry Tympanometry can be used to detect MEE and/or middle ear pressure. Several different instruments, portable and table models, are available. The device screen displays a curve: a tympanogram that is a graphic presentation of the acoustic admittance of the middle ear as a function of altered air pressure (Brookhouser, 1998).