Conditions: Serous otitis media (also known as otitis media with effusion or secretory otitis media)

what is Serous otitis media?

diagnosis of serous otitis media

Serous otitis media impairs the movement the eardrum and therefore dampens sound transmission. This hearing loss is usually what someone with of serous otitis media notices, leading to medical evaluation. An exception, of course, is with children who may not identify or verbalize the problem, in which case serous otitis media may persist until an ear or hearing exam is performed. In a medical setting, serous otitis media is diagnosed by physical examination, which usually includes examination of the eardrum (tympanic membrane) as viewed from the ear canal. Visualization of uninfected fluid in the middle ear, sometimes with the use of pneumatic otoscopy, which is a method of examining the middle ear by using an otoscope with an attached rubber bulb to change the air pressure in the ear canal and visualize how the eardrum reacts. A more objective test of tympanic membrane movement called tympanometry may be conducted when the diagnosis is uncertain. Imaging of the head, such as with a CT or MRI, while not typically undertaken to look for serous otitis media, may incidentally demonstrate the presence of middle ear fluid.

morbidity (health problems) caused by serous otitis media

Serous otitis media, also known as secretory otitis media or otitis media with effusion, involves the accumulation of fluid in the middle ear without the presence of an active infection. While it may seem less alarming compared to acute otitis media, it carries several risks, especially in children.

1. Hearing Loss: The fluid buildup can impede sound transmission, leading to hearing loss. Hearing loss associated with serous otitis media typically resolves when the fluid drains, but in severe or long-standing cases, the middle ear structures may develop scar tissue, potentially leading to a permanent decrease in hearing. An audiogram (hearing test) is used when fluid has been present for 3 months in a child without risk factors for impaired development from serous otitis media, but at the time of diagnosis of serous otitis media with risk factors (noted below).

2. Infection Risk: Although serous otitis media is not an infection itself, it can increase the risk of developing suppurative otitis media. The fluid may become infected, leading to pain and fever.

Preventing Serous Otitis Media

Lessening risk for serous otitis media may be accomplished with the following measures:

Maintain Proper Hygiene

• Encourage regular handwashing to reduce the transmission of respiratory infections.

• Avoid close contact with individuals who have colds or other upper respiratory infections.

Avoid Smoke

• Limit exposure to tobacco smoke, including second-hand smoke, and other environmental pollutants

Treat Upper Respiratory Infections Properly

• Seek medical advice for early treatment of colds and sinus infections.

• Use appropriate medications as prescribed

Vaccinations

• Ensure children are up-to-date on vaccinations, including the pneumococcal and influenza vaccines, which can help reduce the risk of respiratory infections that may lead to serous otitis media.

Minimize Laryngopharyngeal Reflux

• In adults, reflux of stomach contents into the throat (laryngopharyngeal reflux) is a common factor promoting Eustachian tube dysfunction.

Treatment of serous otitis media

In an otherwise healthy individual with serous otitis media, especially when it developed after an upper respiratory infection, observation for three months is a reasonable and safe approach. Not all people are willing to wait three months, however, if the symptoms primarily hearing loss, are bothersome. Children at risk for impaired development as a consequence of serous otitis media (see below) are evaluated closely and the decision to treat may be made sooner or with a lower threshold.

At-risk children and serous otitis media

Special consideration is given to children who are at risk of impaired development with serous otitis media. In these children, treatment shifts from observation to intervention sooner than otherwise normal kids. At risk children include those with the following conditions:

• Permanent hearing loss independent of otitis media with effusion

• Suspected or confirmed speech and language delay or disorder

• Autism spectrum disorder and other pervasive developmental disorders

• Syndromes (eg, Down) or craniofacial disorders that include cognitive, speech, or language delays

• Blindness or uncorrectable visual impairment

• Cleft palate, with or without associated syndrome

• Developmental delay

• Sensory, physical, cognitive, or behavioral factors that place children who have otitis media with effusion at increased risk for developmental difficulties (delay or disorder).