Middle Ear Atelectasis| causes, symptoms, complications and treatment

Definition: Displacement of part or all of the tympanic membrane toward the ossicles and the promontory.

Causes of Middle Ear Atelectasis

1-Prolonged Eustachian tube dysfunction or obstruction.
2-Loss of the fibrous layer of the tympanic membrane through an immune response or due to long standing middle ear effusion.
Middle-ear-atelectasis

Types:
1- Localized or retraction pocket.
2- Diffuse retraction.

complications and sequelae

1-Tympanic membrane perforation.
2-Ossicular erosion.
3-Cholesteatoma formation.

Symptoms:

Deafness, or may be asymptomatic.

Signs:

Collapse of the tympanic membrane on the promontory without adhesion.

Investigations:

PTA reveals conductive hearing loss. Impedance audiometer reveals type C curve due to Eustachian tube obstruction.

Treatment of Middle Ear Atelectasis

Conservative:
 It is effective in early cases. It includes exercises to ventilate the Eustachian tube as Valsalva maneuver, politzerization and continuous positive airway pressure (CPAP).

Surgical:
 Myringotomy with ventilation tube insertion. Cartilage tympanoplasty is indicated in severe cases.

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