Believe
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A 6-year-old boy says his left ear hurts. His mother says that he has been tugging the ear. The external canal and tympanic membrane appear normal, but the tympanic membrane does not move when the pressure in the nasopharynx is increased. Which of the following is the most likely cause of these findings?
A) Auditory tube obstruction
B) Cholesteatoma
C) Otitis externa
D) Purulent otitis media
E) Serous otitis media
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| cyra
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A
With obstruction of the auditory tube theere would be absorption of air in the middle ear...and the tympanic memebrane will be pulled inwards and so will not move with changes in pressure in the nasopharynx.
The external canal appears normal and so does the appearence of the tympanic memebrane,ruling out the other options.
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| reet
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A agree with cyra
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| roopashri
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i think serous otitis media
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| Believe
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In Serous Otitis Media, there is often a collection of fluid in the middle ear. This may be acute or chronic. Acute serous otitis media is usually the result of blockage of the eustachian tube from an upper respiratory infection or an attack of nasal allergy. In the presence of bacteria this fluid may become infected leading to an acute suppurative Otitis Media (infected or abscessed middle ear).
Otoscopy:
The normal Timpanic Membrane is gray, concave, and translucent and moves briskly on pneumatic otoscopy.
The classic signs of Acute Otitis Media are redness and bulging of the TM. In the beginning stages of AOM, the eardrum may bulge outward because of positive pressure in the middle ear, and it often moves normally. As effusion develops, drum mobility is decreased even annulated. In severe cases none of the usual landmarks may be visible. If the process continues to worsen, necrosis of the TM occurs and the effusion passes into the ear canal through a typically pinpoint perforation. Massive necrosis of the drumhead is rare, although necrotizing streptococcal infection is a known cause of permanent perforation.
Edited by Believe on 12/09/05 - 04:33 PM
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| msyamp
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The external canal and tympanic membrane appear normal
this is the answer to the question!! right? this cannot be D because there are no signs on tympanic membrane
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| cyra
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Hmmm...bear with me guys...but the questions says that the tympanic membrane doesnot move when the pressure in the nasopharynx is increased.....now the only thing that serves to equalise pressure between the middle ear and the nasopharynx is the eustachian tube....and when it does so the tympanic membrane moves....so the tube has to be blcokes/obstructed.....what is confusing me is that auditory tube blockade is seen in seous otitis media as well.... .....arrghhh....help!!!
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| msyamp
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yes but the thing here is NO SIGNS ON THE TYMPANIC MEMBRANE which means that there is no serous otitis developed yet. it is just obstuction of the tube.
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| anu_millenium
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yeah i agre wit u..it has to b eustasian tube block..guys wake upp..!!in serous otitis media t.m is bulging plus there r vescicles n bullae seen..colour also not normal..come on..!!
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| cyra
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Thankyou!
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| Believe
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thanks for the explanation guys
Edited by Believe on 12/27/05 - 07:24 PM
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| hellohie
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THANX BELIEVE.
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| X-Ray
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Thanks so much for the photos and clarification on this subject
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| docsrinu
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so the ans is A.
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