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Suggest treatment for middle ear effusion

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Posted on Thu, 21 May 2015
Question: Dear Doctor,
I am looking for your opinion based on test report attached and history.
History:
2 months back I had cold and cough. on presicription of family physician I had taken medicine for two weeks. But did not get relieve from cold. whitish sticky mucus was continuously coming from my nose and I expereienced hearing loss from my right ear. My left ear already had moderate severe hearing loss since couple of years
I have visit to ENT specialist (1). who further given my some antibiotics and nasal spray (Furamist) and ear drop ofloxacin for left ear having infection. There was no improvement in hearing but there was releif in mucus.But again no improvement hearing.
I have visited another ENT specialist in the last week who has advised Audiometry and impedance Test and also prescribed some antibiotics and Otrivin Nasal drops.
The test report is attached for your reference.
The ENT specialist has advised me for procedure on both the ear. Where as per the report suggest only moderate severe hearing loss.
Please advise should I agree for procedure?
By mistake there are 4 irrelavant pages uploaded along with report. Sorry for the inconvenience.
doctor
Answered by Dr. Sumit Bhatti (26 minutes later)
Brief Answer:
Type B Tympanogram.Fluid in middle ear.Myringotomy+grommet if meds fail.

Detailed Answer:
Hi,

Thank you for your query.

1. The report shows a Type B (Flat) Tympanogram. This suggest fluid build-up in the middle ear (middle ear effusion).

2. A bilateral myringotomy with grommet insertion under local anesthesia can be done if there is no response to medication for 4-8 weeks.

3. The procedure is safe and effective.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Sumit Bhatti (28 minutes later)
thank you sir.

I was worried only when ENT specialist enquiried about my medical insurance after reviewing the report and advised procedure for next week,

Ok based on your advise surely I will go for procedure.

doctor
Answered by Dr. Sumit Bhatti (8 minutes later)
Brief Answer:
Repeat the tests next week. Check exact procedure/s that are planned.

Detailed Answer:
Hi,

Thank you for writing back.

1. There is a wide variation in the charges for this procedure from hospital to hospital.

2. Remember to repeat this test next week before the final decision to go ahead with the procedure. Upload the report.

3. Check the left ear again as a discharge could mean that there is an ear drum perforation. With a high ECV reading and thick discharge, there may be an ear drum perforation in the left ear.

4. Confirm the exact procedure/s planned and expected charges from the Specialist and revert. It is also possible that a left Tympanoplasty is being planned. I need to see the PTA (Pure Tone Audiometry). Kindly upload this report.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Sumit Bhatti (22 minutes later)
Sir
I have uploaded a PDF file having 4 pages of report.

secondly my worry was not money but the hurriness from the specialist for pocedure. thanks for guidence.

Shall look foward to hear from you. thank you,
doctor
Answered by Dr. Sumit Bhatti (17 minutes later)
Brief Answer:
The details are explained in this answer.

Detailed Answer:
Hi,

Thank you for writing back.

1. So you have a perforation in the left ear on examination and a mixed hearing loss on both sides.

2. This means that if the procedure planned is a left Tympanoplasty, you should wait till the ear is dry (no discharge) and beyond that for at least 3 weeks (ideally 3 months) before operating as this increases the success rate. The mixed hearing loss means that your hearing will not return to normal after the operation, but the ear should become dry.

3. If the procedure planned is Myringotomy + grommet for the right ear, you should repeat the tests next week and then you can go ahead if there is no change. If the tests show improvement, only medical managment is necessary for the right ear.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2662 Questions

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Suggest treatment for middle ear effusion

Brief Answer: Type B Tympanogram.Fluid in middle ear.Myringotomy+grommet if meds fail. Detailed Answer: Hi, Thank you for your query. 1. The report shows a Type B (Flat) Tympanogram. This suggest fluid build-up in the middle ear (middle ear effusion). 2. A bilateral myringotomy with grommet insertion under local anesthesia can be done if there is no response to medication for 4-8 weeks. 3. The procedure is safe and effective. I hope that I have answered your query. If you have any more questions I will be available to answer them. Regards.