Prof. Dr. Şenol Polat

Ventilation Tube Insertion To The Ear – Fluid Accumulation In The Middle Ear And Serous Otitis Media

How does fluid accumulation develop in the ear?
The middle ear is a partially closed cavity. It opens into the throat with the eustachian tube and ventures into the bone called the mastoid that is behind the ear. The eustachian tube allows the fluid produced by the surface in the middle ear to flow into the throat. It also plays a major role in ventilating the middle ear and maintaining its pressure. The eustachian tube may become clogged (for example, when adenoid hypertrophy occur, it will clog the eustachian’s mouth, and the eustachian can not serve) or the eustachian’s function may be impaired. In this case, fluid accumulation in the middle ear, aeration and pressure disturbances develop. Although this fluid accumulated in the middle ear is not infected, it is not an innocent liquid and there is a possibility of damaging the middle ear structures (eardrum and ossicles). Fluid accumulation in the middle ear is called ‘serous’ or ‘secretory otitis medi’.

What happens if the accumulation of fluid in the middle ear is not treated for a long time (for example, more than 3 months)?
1. The middle ear structures and eardrum begin to hurt.

2. Hearing loss in the person can impair social and intellectual development.

3. Thinning of the eardrum, collapsing to the middle ear, or tears, punctures may be seen.

Therefore, fluid accumulation in the middle ear needs to be treated. For treatment, the underlying causes should be investigated first. Allergic diseases, nasal and sinus infections or anatomical problems, eustachian tube dysfunctions or obstructions, adenoid diseases are the leading causes.

What is the treatment of fluid accumulation in the middle ear?
Medical treatments (including antibiotics) of fluid accumulation in the middle ear are controversial. Fortunately, fluid buildup in the middle ear often heals on its own. However, in cases where there is no improvement, if there is no response to long-term medical treatment, it is necessary to drain the fluid (to make a paracentesis by opening a microscopic hole in the eardrum) or tube application. These tubes are very small (diameters of the tubes used are between 1.14 – 1.52 mm). These tubes provide the aeration and pressure balance of the middle ear, and help with its drainage if necessary. Tubes placed in the eardrum fall out automatically, either early or late, depending on their type. In rare cases, the tubes may not fall off spontaneously in the expected time, in which case they are removed by the physician. After the tubes are removed, the eardrum renews itself in a short time without damage and the tube area is closed. Very rarely, if a large diameter tube is inserted and the tube has been left there for a long time (more than 1-1.5 years) or if the person have dysfunction in the middle ear or eustachian tube continuesly, perforation may occur. After the tube is inserted into the ear, the ear should be protected from water due to the risk of infection in this ear. It is recommended to close the outer ear canal while taking a bath, swimming in the pool and the sea.


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