Otitis Media With Effusion Differential Diagnoses

  • Author: Richard D Thrasher III, MD; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Oct 7, 2011
 
 

Diagnostic Considerations

In adults, recognizing unilateral otitis media (OME) with effusion is crucial. This entity must be considered a nasopharyngeal mass until definitively proven otherwise. Note that the single greatest pitfall in otitis media with effusion is the failure to fully evaluate a potential nasopharyngeal mass in an adult patient who has recurrent unilateral otitis media with effusion. At minimum, indirect mirror examination or flexible nasopharyngoscopy should be performed. Imaging studies and possibly even biopsies may be indicated.

Other pitfalls include the failure to note hearing loss and the failure to recognize a potential delay in language development in children; these failures could have a lasting effect in the patient.

The following are conditions that should be considered when evaluating patients with suspected otitis media with effusion:

  • Benign nasopharyngeal masses
  • Nasopharyngeal carcinoma
  • Acute otitis media (AOM)
  • Adenoid hypertrophy
  • Congenital defects affecting the eustachian tube and its egress
  • Ciliary dyskinesia
  • Immunoglobulin G (IgG) subclass deficiencies

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Richard D Thrasher III, MD  Private Practice, McKinney, Texas

Richard D Thrasher III, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, and American Rhinologic Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Chief Editor

Arlen D Meyers, MD, MBA  Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo Consulting; Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting; GYRUS ACMI Honoraria Consulting

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author Gregory C Allen, MD, to the development and writing of the source article.

References

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