Secretory otitis media is a non-suppurative inflammation of the middle ear mucosa, characterized clinically by fluid accumulation in the tympanic chamber and hearing loss. There are acute and chronic secretory otitis media.
1. Clinical manifestations.
(1) History: Acute cases mostly have a history of recent cold or inflammation of the nose and nasopharynx. Chronic cases can be caused by acute cases that have not been properly treated or by the conversion of acute cases into repeated attacks, or by lesions in the nasal cavity and nasopharynx that affect the function of the eustachian tube.
(2) Symptoms: Hearing loss, ear stuffiness or blockage sensation, which can be temporarily relieved by pressing the ear screen or pinching and puffing the nose. Acute onset may be accompanied by ear pain, low-pitched tinnitus or a gas-over-water sound when gas enters the middle ear through the eustachian tube.
(3) Signs: Invagination of the tympanic membrane (loss or deformation of the light cone). Fluid accumulation in the tympanic chamber, the tympanic membrane may become yellowish, amber or see a fluid flat line. Restricted tympanic membrane activity.
2. Auxiliary examinations.
(1) Hearing examination.
Pure-tone audiometry – presents conductive deafness.
Acoustic conductivity – tympanic chamber pressure curve is flat or negative.
(2) Nasopharyngeal examination: Exclude adenoid hypertrophy and nasopharyngeal tumor.
Treatment principle: remove middle ear fluid, improve eustachian tube function, etiological treatment.
3. Etiological treatment.
(1) Systemic treatment, including treatment of upper respiratory tract infection and anti-allergy.
(2) Treatment of nasal and nasopharyngeal disorders to keep the nasal cavity and the pharyngeal opening of the eustachian tube open.
4. Removal of middle ear fluid, depending on the condition, the following methods can be chosen.
(1) Tympanic membrane puncture;
(2) Laser perforation of the tympanic membrane;
(3) tympanotomy;
(4) Tympanic chamber tube placement;
(5) Tympanoplasty.