Chad, a 5-year-old preschooler, is brought to the clinic due to an ear problem. Which assessment data would cause the nurse to suspect serous otitis media?
A. Bright red, bulging, or retracted tympanic membrane and fever.
B. Inflammation of the external ear and crust formation on the auditory canal.
C. Sensorineural hearing loss and complaints of tinnitus.
D. Plugged feeling in the ear and reverberation of the client's own voice.
Correct Answer: D. Plugged feeling in the ear and reverberation of the client’s own voice.
Serous otitis media is manifested by a plugged feeling in the ear, reverberation of the client’s own voice, and hearing loss. In many instances, they will have the symptom of aural fullness or a sensation that the ear is popping. In adults, serous otitis media or otitis media with effusion is more often unilateral. Adult patients may report tinnitus and the sensation of a foreign body in the external auditory canal.
Option A: A bright red, bulging, or retracted tympanic membrane and fever suggest suppurative otitis media. By inspecting the ears, the degree of tympanic membrane mobility in response to negative or positive pressure can be evaluated to assess for fluid in the middle ear, a hallmark of otitis media. Other abnormalities in the tympanic membrane found are erythema, bulging or fullness, or extreme retraction.
Option B: Inflammation of the external ear and crust formation on the auditory canal suggest external otitis media. Otoscopy will reveal an erythematous and edematous ear canal with associated debris (yellow, white, or gray). In some cases, the tympanic membrane is erythematous or partially visualized due to edema of the external auditory canal.
Option C: Sensorineural hearing loss and tinnitus indicate otosclerosis. Otosclerosis, also called otospongiosis, is an abnormal bone remodeling in the middle ear in which a normal dense endochondral layer of bony otic capsule in the bony labyrinth is replaced by one or more foci of irregularly laid spongy bone and most commonly involves the stapes region.
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