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Otitis Media with Effusion [OME]

Yellowish fluid filling the middle ear cavity.

Bulging eardrum with turbid middle ear effusion

complicating upper respiratory tract infection.

Thin straw-colured fluid filling middle ear cleft

with mild eardrum retraction.

Straw-coloured middle ear effusion.

Effusion with air bubbles.

A lesser effusion with air bubbles and significant eardrum retraction.


Blood-tinged effusion: consider barotrauma if no obvious source of infection. 

Eardrum retraction, more horizontally aligned lateral process,

and distorted cone of light reflex.


Pronounced pars flaccida retraction and the lesser pars tensa with yellowish effusion seen. 


Middle ear effusion with a retracted tympanic membrane. 

Yellow middle ear effusion seen at upper segment of middle ear compartment.


 Retracted tympanic membrane in resolving OME. 

The normal cone of light is absent.

Otitis Media with Effusion [OME] & Retraction of Pars Tensa + Pars Flaccida

A rounded atrophic area is seen over antero-inferior segment

where ventilation tube/grommet was previously inserted.

Otitis Media with Effusion [OME] & Eardrum Retraction

                         Figure 1                                                Figure 2


This eardrum is retracted involving both of its pars flaccida and pars tensa.  There is middle ear effusion secondary to longstanding negative middle ear pressure.


Figure 1: Dull eardrum appearance with distorted cone of light reflex

Figure 2: An atrophic central pars tensa which draped onto the promontory


OME with Myringosclerosis

Retracted Eardrum

Cleft Palate as Predisposing Factor to Chronic Eustachian Dysfunction and OME Formation

Gross cleft palate in an adult.  Nasal regurgitation, bathing of Eustachian introitus with refluxate, and loss of tubal protection predispose to chronic Eustachian tube dysfunction, negative middle ear pressure, and glue ear formation.

Rhinogenic Otitis Media

 Tenacious mucopus being sucked out from right nasopharyngeal Eustachian tube opening.  This patient has pansinutitis and presented with irritable coughs of more than 4 weeks.  Otoendoscopy revealed bilateral glue ear.

The similar tenacious mucopus from left nasopharyngeal Eustachian tube opening.


[Arrow - Eustachian tube opening, TT - torus tubarius, mp - mucopus]