摘要
Abstract
Objective To analyze the causes of misdiagnosis of adult secretory otitis media(SOM).Methods A total of 16 adult patients with SOM misdiagnosed from March 2021 to September 2022 were selected and the process of diagno-sis and treatment was analyzed.Results Among the 16 cases,14 patients had a history of upper respiratory tract infection at 15 d before onset,2 had a history of suppurative maxillary sinusitis,and 2 had a history of noise exposure.All 16 cases pres-ented with ear occlusion,tinnitus(low pitch),hearing loss as the main complaint,and 4 cases were accompanied by mild earache.Otoscopy showed that 16 had tympanic membrane opacity and invagination,which was amber or light yellow in color,and no liquid flat line or bubble was found.The initial diagnosis was sensorineural deafness in 2 cases and sudden deafness in 14 cases.The symptoms did not improve after corresponding treatment.Combined with relevant medical history and otoscopy results,tympanic sound immittance test(B-type tympanic immittance map)and tympanocentesis(yellowish viscous fluid was extracted)were performed to confirm SOM.Misdiagnosis lasted from 7 to 52 d.The patient was cured after treatment,inclu-ding tympanic membrane puncture,and nasal contraction agent.Conclusion The main symptoms of adult SOM are mild ear pain,hearing loss,ear distension,occlusive feeling and tinnitus,which are similar to many middle ear diseases.For patients with sudden hearing loss,ear occlusion,and tinnitus as the main symptoms,the relevant medical history should be inquired in detail,the tympanic membrane changes and tympanic effusion should be carefully observed,and the acoustic immittance ex-amination and tympanocentesis should be performed as soon as possible for early diagnosis.关键词
伴渗出液中耳炎/成人/误诊/听觉丧失,感音神经性/突发性聋/呼吸道感染/声导抗检查/中耳通气Key words
Otitis media with effusion/Adult/Misdiagnosis/Hearing loss,sensorineural/Sudden deafness/Respir-atory tract infections/Acoustic immittance examination/Middle ear ventilation分类
医药卫生
