Pathophysiology of otitis media with effusion: clinical evaluation through some qualitative methods.

In an attempt to elucidate the pathophysiology of otitis media with effusion (OME), systematic clinical investigations were undertaken. The high resolution computed tomography, tympanogram, tubal inflation and our qualitative tubal functioning test were routinely applied to cases of OME, both in children and adults. Through these studies, following was concluded: 1. The primary pathology involved may be obstructive lesion somewhere in the tubotympanic cleft including the epitympanum and the mastoid, which in turn results in negative pressure in the middle ear. 2. This negative middle ear pressure may mainly constitute the Eustachian tube dysfunction, which is considered to play an important role in the pathogenesis of OME. Discussed in detail further will be the importance of correcting the negative middle ear pressure substantially for the treatment of OME, and also the essence of our qualitative tubal functioning test.