The nurse practitioner assesses a patient with suspected otitis media with effusion. Which of the following findings would most support this diagnosis during the physical examination?
Otitis media with effusion (OME) is characterized by the accumulation of fluid in the middle ear without signs of acute infection. During physical examination, decreased mobility of the tympanic membrane when assessed with pneumatic otoscopy is a hallmark finding, indicating the presence of fluid behind the membrane. The nurse practitioner uses a pneumatic otoscope to gently puff air into the canal to observe how the eardrum responds. The eardrum will appear dull and retracted and have decreased mobility. Amber fluid in otitis media with effusion results from sterile serous or mucoid buildup in the middle ear due to Eustachian tube dysfunction, often appearing yellowish when viewed through the tympanic membrane. This differs from acute otitis media, which typically presents with a bulging, erythematous tympanic membrane due to infection and inflammation. Tenderness and swelling of the external ear canal suggest otitis externa, while purulent discharge indicates an infectious process typically associated with acute otitis media or otitis externa rather than OME.
When studying ear conditions, create a chart that outlines the key findings, symptoms, diagnosis, and treatment of otitis media with effusion, acute otitis media, and otitis externa. These are commonly tested, and a chart will help reinforce your knowledge so you can recognize those key differences on test day.