Diagnostic assessment and various treatment modalities of secretary otitis media

Abstract

Background: Secretary Otitis Media (SOM) is the commonest cause of hearing difficulty in childhood encountered by the Otologist. It is characterized by accumulation of effusion in the middle ear cavity due to altered mucociliary system within middle ear and Eustachian tube.Objectives: To study the common clinical features of Secretary Otitis Media (SOM) and its various treatment modalities.Methods: In our study total 55 subjects with secretary otitis media in less than or equal to 13 years of age were assessed. Demographic data, detail case history and Clinical examination were recorded. Complete otolaryngological examination including ear, TFT, ET Function, nose and throat. Blood investigations, urine examination, audiological examinations like pure tone audiometry and impedance audiometry, Urine investigation, Radiological examinations were performed. Microbiological testing of ear effusion and diagnostic nasal endoscopy (DNE) were performed. All the patients were treated first on medical line then followed up for 4 weeks. Refractory cases were considered for surgical modality of treatment like myringotomy with grommet insertion, adenoidectomy with grommet insertion and adenotonsillectomy with grommet insertion.Results: Most of the cases showed significant improvement in signs and symptoms. Good results were seen mostly in patients who had undergone adenotonsillectomy, adenoidectomy with grommet insertion and in hearing threshold. Post operatively most common complication found was mucopurulent discharge after grommet insertion and at electasis changes. Conclusion: Attention should be paid to parental concern regarding their child’s hearing particularly if there is a recent history of acute otitis media.