XXXV Classification of Middle Ear Effusions

Abstract

There seems to be very little agreement as to a classification of middle ear effusions despite efforts to eliminate the differences in terminology. In this report the literature will be reviewed and recommendations made with regard to classification. A. NOMENCLATUREA confusing number of terms are still used to describe the various types of effusion found. Reports appearing in the literature on the general subject of middle ear effusion refer to catarrhal otitis," adhesive otitis,8.24,41 secretory otitiS/,12.23.45 serous otitis," secretory catarrh," and glue ear. 25The differential diagnosis of effusions is commonly based on morphologic findings, i.e., appearance and position of the tympanic membrane, the presence or absence of fluid in the middle ear, the patency of the lumen of the Eustachian tube and the audiologic findings. In the hands of the knowledgeable and experienced otologist a correct diagnosis based on these observations can be made in a high percentage of patients, but mistakes do occur.The physical characteristics of the effusions provide additional information which may be used to classify them. Thus, the clear, low viscosity fluid is commonly referred to as serous or secretory; the milky viscous effusion is referred to as secretory, exudative or glue-like; the opaque milky fluid seen in acute otitis media is described as suppurative or purulent.On the basis of history, otologic and physical findings, and cytologic and biochemical data, which will be presented later, a work-

Ultrasound characterization of middle ear effusion

“…18 Similar results were obtained by Liu et al 19 In this study, 59% of serous effusions were culture-positive compared to 37% of mucoid effusions. An accurate diagnosis of the middle ear via ultrasound assessment provides physicians further information of the middle ear effusion characteristic beyond conventional otoscopic examination.…”