Case history
Case history #1
A 3-year-old girl presents with a history of speech delay. She had one ear infection at 1 year of age but has had none since. She had a hearing screen at her primary care provider’s office and failed on both sides. Her mother states that sometimes she pulls at her ears; otherwise, there are no symptoms. On examination, the tympanic membranes appear retracted and there are straw-coloured effusions bilaterally.
Case history #2
A 25-year-old man presents with a 1-month history of aural fullness following a cold. He states that it feels like he is hearing underwater, and it is significantly impacting his work. He does not have tinnitus, otorrhoea, or vertigo. He had an audiogram in the community, which showed mild conductive hearing loss bilaterally with type B (flat) tympanograms. On examination using pneumatic otoscopy, the tympanic membranes have a dark hue and showed no movement.
Other presentations
Pre-lingual children with chronic OME (defined as fluid present in the middle ear for ≥ 3 months) may present after failing a routine hearing screen through their primary care provider. They may also present with imbalance and impaired gross motor skills as OME can affect the peripheral vestibular system.[3][4] Given the overlap between Eustachian tube dysfunction and OME, children and adults may also present with symptoms of Eustachian tube dysfunction, such as ear ‘popping’ or tinnitus.
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