上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin...
-
Upload
veronica-mitchell -
Category
Documents
-
view
245 -
download
0
Transcript of 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin...
![Page 1: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/1.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Secretory otitis media
Shankai Yin Prof Dept of Otolaryngology, the sixth hospital
affiliated to Shanghai jiaotong university Otolaryngology institute at Shanghai
jiaotong university
![Page 2: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/2.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Denomination
Otitis media with effusion Exudative otitis media Mucoid otitis media Catarrhal otitis media Tubotympanitis Non-suppurative otitis media………… Secretory otitis media
1991 我国自然科学名词审定委员会
![Page 3: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/3.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Pathology
Middle ear effusionSerofluid 、 Mucus 、 Sero-mucous , non blood
or CSF
Epithelium mucosae thicken , Epithelial
metaplasiaPseudostratified columnar ciliated epithelium
Secretory epithelium
![Page 4: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/4.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Epidemiology
Main in children 5.2-21.6% ( by aural speculum , Hongkong ), 7.3-30.7% ( by acoustic impedance , Hongkong ) in 2-7 year-old
15-40% ( 2004 , USA ) in 1-5 year-old 3.8% in 2 year-old , 1.1% in 11 year-
old ( Suarez Nieto , 1983 , USA) More than 50% infant occurs , most
natural cure in 3 months
![Page 5: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/5.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Etiology
Eustachian tube dysfunction Eustachian tube blockage
Ciliary dysfunction
Infection
Immune reaction
![Page 6: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/6.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Eustachian tube dysfunction
Disease in pharynx nasalis Adenoidal hypertrophy Nasopharyngeal carcinoma
Tumour from parapharyngeal space
![Page 7: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/7.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Eustachian tube dysfunction
Circumflexus palati 、 levator palati weak
Cartilage of eustachian tube problem
![Page 8: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/8.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Eustachian tube dysfunction
Rhinosinusitis Nasal polypus
![Page 9: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/9.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Infection
Germ in excretion of mid ear ( Senturia , 1958 )
22-52% positive in excretion of mid ear
Hemophilies influenzae ( 14.7% , USA ) and micrococcus pneumoniae ( 7.0% , USA ) are the main pathogenic bacterium
Also influenzavirus 、 adenovirus 、 chalmdiae trachomatis
![Page 10: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/10.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Immune reaction
Type I Allergic rhinitis
Nasal polyp
Bronchial asthma
Type III Bacterium in adenoid and pharynx oralis
![Page 11: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/11.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Clinical manifestation
Common cold Hearing disturbance Earache Fural fullness Tinnitus
![Page 12: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/12.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Objective sign
Deaphragma auris Hyperemia Invagination Mobility diminished
Cavum tympani Fluidify Air bubble
![Page 13: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/13.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Objective sign
Pure tone test Conductive hearing loss
![Page 14: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/14.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Objective sign
Combined deafness deafness Bacterium or toxin reach inner ear by RWM HC hurt
![Page 15: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/15.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Objective sign
Acoustic impedance Type B : typical plot Type C : eustachian tube dysfunction
![Page 16: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/16.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Differential diagnosis
Nasopharyngeal carcinoma Single secretory otitis media , adult ,
lump in neck , epistaxis Epipharyngoscope , CT , MRI
Cerebrospinal otorrhea Trauma or congenital deafness Temporal bone CT
![Page 17: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/17.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Perilymphorrhea Stapes operation , sudden deafness Tullio phenomenon
Cholesterol granuloma Sequela of secretory otitis media Dark blue eardrum Temporal bone CT
Differential diagnosis
![Page 18: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/18.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Spontaneous cure Etilogical treatment
Adenoidectomy Amygdalectomy FESS Explorative tympanotomy
![Page 19: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/19.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Drug treatment Antibiotic Glucocorticosteroid Decongestant Ambroxol
![Page 20: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/20.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Eustachian tube inflation
![Page 21: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/21.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Paracentesis tympani
Both diagnosis and treatment
![Page 22: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/22.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Paracentesis tympani Surface anesthesia Only adult Asepsis Complication
infection,impairment of RWMauditory ossicle fenestration oval window
![Page 23: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/23.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Myringotomy Cutter knife Carbon Dioxide laser
![Page 24: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/24.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Grommet insertion
![Page 25: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/25.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Treatment
Grommet insertion Indication
inefficacy of myringotomyglue earhearing loss : 40db
Complication Tympanosclerosis Permanence perforation of ear drum Chronic suppurative otitis media Sensorineural deafness
![Page 26: 上海市第六人民医院 Shanghai Sixth People’s Hospital Secretory otitis media Shankai Yin Prof Dept of Otolaryngology, the sixth hospital affiliated to Shanghai jiaotong.](https://reader030.fdocuments.us/reader030/viewer/2022033015/56649dc95503460f94abed4a/html5/thumbnails/26.jpg)
上海市第六人民医院Shanghai Sixth People’s Hospital
Thank you