java barcode generator download DISEASES OF THE AUDITORY TUBE 1 Eustachian Tube Dysfunction in Objective-C

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DISEASES OF THE AUDITORY TUBE 1 Eustachian Tube Dysfunction
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Aural fullness Fluctuating hearing Discomfort with barometric pressure change At risk for serous otitis media The tube that connects the middle ear to the nasopharynx the eustachian tube provides ventilation and drainage for the middle ear cleft It is normally closed, opening only during the act of swallowing or yawning
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Blocked eustachian tube remains for a prolonged period Resultant negative pressure will result in transudation of fluid
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episodes of barotrauma in persons who must fly frequently may be alleviated by insertion of ventilating tubes Underwater diving may represent an even a greater barometric stress to the ear than flying The problem occurs most commonly during the descent phase, when pain develops within the first 15 feet if inflation of the middle ear via the eustachian tube has not occurred Divers must descend slowly and equilibrate in stages to avoid the development of severely negative pressures in the tympanum that may result in hemorrhage (hemotympanum) or perilymphatic fistula In the latter, the oval or round window ruptures, resulting in sensory hearing loss and acute vertigo Emesis due to acute labyrinthine dysfunction can be very dangerous during an underwater dive Sensory hearing loss or vertigo, which develops during the ascent phase of a saturation dive, may be the first (or only) symptom of decompression sickness Immediate recompression will return intravascular gas bubbles to solution and restore the inner ear microcirculation Patients should be warned to avoid diving when they have upper respiratory infections or episodes of nasal allergy Tympanic membrane perforation is an absolute contraindication to diving, as the patient will experience an unbalanced thermal stimulus to the semicircular canals and may experience vertigo, disorientation, and even emesis Finally, persons with only one hearing ear should be discouraged from diving because of the significant risk of otologic injury
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Mirza S et al Otic barotrauma from air travel J Laryngol Otol 2005 May;119(5):366 70 [PMID: 15949100]
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When the eustachian tube remains blocked for a prolonged period, the resultant negative pressure will result in transudation of fluid This condition, known as serous otitis media, is especially common in children because their eustachian tubes are narrower and more horizontal in orientation than those in adults Serous otitis media is less common in adults, in whom it usually occurs after an upper respiratory tract infection, with barotrauma, or with chronic allergic rhinitis In any adult with persistent unilateral serous otitis media, nasopharyngeal carcinoma must be excluded The tympanic membrane in serous otitis media is dull and hypomobile, occasionally accompanied by air bubbles in the middle ear and conductive hearing loss The treatment of serous otitis media is similar to that for eustachian tube dysfunction A short course of oral corticosteroids (eg, prednisone, 40 mg/d for 7 days) has been advocated by some clinicians, as have oral antibiotics (eg, amoxicillin, 250 mg orally three times daily for 7 days) or even a combination of the two The role of these regimens remains controversial, but they are probably of little lasting benefit When medication fails to bring relief after several months, a ventilating tube placed through the tympanic membrane may restore hearing and alleviate the sense of aural fullness Endoscopically guided laser expansion of the nasopharyngeal orifice of the auditory tube may improve function in recalcitrant cases
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Dogru H et al Squamous cell metaplasia of the nasopharyngeal epithelium and its association with adult-onset otitis media with effusion Acta Otolaryngol 2005 Jun;125(6):580 4 [PMID: 16076705] Kujawski OB et al Laser eustachian tuboplasty Otol Neurotol 2004 Jan;25(1):1 8 [PMID: 14724483] Satre TJ et al Treatments for persistent otitis media with effusion Am Fam Physician 2005 Feb 1;71(3):529 30 [PMID: 15712626]
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