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Otitis media with effusion in a patient who had previously undergone a stapedectomy.

A 55-year-old woman presented with a 6-week history of decreased hearing and a sensation of fullness in her left ear. Her symptoms arose following an upper respiratory tract infection. She also reported otalgia soon alter the onset of a cold 6 weeks earlier. The pain abated following antibiotic therapy, which had been prescribed by her primary care physician. However, the left ear fullness and the diminished hearing persisted. She had no history of vertigo, but she did report intermittent tinnitus. Of note, she said that she had undergone a stapedectomy 25 years earlier, and her postoperative hearing was good.

On examination, the tympanic membrane was retracted and a straw-colored fluid could be seen behind an intact tympanic membrane (figure). The tympanic membrane was in contact with the long process of the incus, and the wire loop of the stapedectomy prosthesis could be seen through it. Bone conduction was greater than air conduction on a tuning fork test, and Weber's test lateralized to the left. An audiogram confirmed these findings. Clinical and audiologic correlates of labyrinthitis were not present.

[FIGURE OMITTED]

Myringotomy and ventilation tube placement reversed the conductive hearing loss, and the patient remained well during follow-up.

From the Division of Otology/Neurotology, the Department of Otolaryngology--Head and Neck Surgery, University of Texas Medical Branch at Galveston.
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Title Annotation:OTOSCOPIC CLINIC
Author:Gadre, Arun K.
Publication:Ear, Nose and Throat Journal
Geographic Code:1USA
Date:Aug 1, 2005
Words:217
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