The culprit that steals children’s hearing Mom, why is it so noisy outside? This was the first thing Ming Ming said to his mother when he woke up. However, the only sound in the ward was from the TV, which was not too loud. However, it sounded very uncomfortable to him, who had just undergone surgery. This was because his hearing had not been this good for a long time, as his hearing had been significantly reduced before the surgery due to secretory otitis media. Secretory otitis media was previously also known as non-suppurative otitis media, catarrhal otitis media, etc., due to the absence of ear pus or obvious ear pain symptoms. For example, Ming Ming was a very obedient child. However, for a while, his mother noticed that when she spoke to him, he was always unresponsive or did not answer questions. His teacher also complained that Ming Ming was not paying attention in class recently and liked to look around. In fact, all this was due to Ming’s suffering from secretory otitis media, which caused a slow decline in hearing. Yet all this happened quietly, without any obvious discomfort to Ming. It wasn’t until his mother finally wondered if there was something wrong with her child’s hearing and brought Mingming to the hospital for an examination that she found out. Only at this point, Ming Ming could only undergo surgery. The culprit, the only channel blocked The middle ear is separated from the outside world by a layer of tympanic membrane, so the only contact channel is a bit convoluted, and that is through the eustachian tube to the nasal cavity and then to the outside world, which allows the air pressure in the middle ear and the outside world to remain basically the same. If there is a malfunction in this pathway, such as a cold or fever, and the mucous membrane in the eustachian tube swells and blocks it, the middle ear cannot communicate with the outside world, and it becomes a “secret chamber”. As the air in the middle ear is slowly absorbed, the air pressure becomes smaller than that of the outside world, and the eardrum is squeezed towards the middle ear by atmospheric pressure, resulting in a feeling of stuffiness and swelling in the ear. In addition, this negative pressure affects the mucous membrane inside the ear, causing it to secrete more fluid. However, the middle ear is cut off from the outside world, so the fluid remains in the ear and cannot exit. This results in a secretory otitis media. The negative pressure and fluid in the middle ear can lead to hearing loss. Secretory otitis media, which “favors” children Otitis media is very common in children, with more than 80% of children in the United States having had at least one otitis media. This is because the eustachian tube of children has its own characteristics: the eustachian tube of young children is still in the growth and development stage and is relatively wide and flat; the “gatekeeper” muscle of the eustachian tube is weakly contracted, which affects the open function of the eustachian tube; the cartilage of the eustachian tube of children is less elastic, and when the middle ear is under negative pressure, the wall of the eustachian tube tends to collapse, which further When the middle ear is under negative pressure, the wall of the eustachian tube will easily collapse, thus further increasing the negative pressure in the tympanic chamber and leading to fluid accumulation in the tympanic chamber. In addition, children have poor resistance and immune function, so they are prone to recurrent upper respiratory tract infections, and congestion and swelling of the nasal mucosa cause the opening of the eustachian tube to become smaller and the lumen to become narrower. These are the reasons why children are prone to otitis media. In acute cases, there may be mild ear pain, while in chronic cases, there is no obvious ear pain or other discomfort. Patients mostly have a little stuffy feeling in their ears, like a blockage of cotton. Hearing loss is also common, but it is usually slow, so it may not be easily detected early on without attention. The stuffiness and hearing loss improve when the patient is lying down, but return to normal when the patient stands up. In addition, the patient may feel loud when he or she speaks on their own. If parents find that their child is unresponsive to sound and has difficulty paying attention, they should consider whether the child has hearing loss and take the child to the hospital for an examination in a timely manner. Surgery to “build” an eustachian tube In the early stages, conservative treatment with medication can be used. However, if the lesion is more severe and has a longer duration, surgery may be necessary. Surgery is also simple, except that general anesthesia is used because of the child’s cooperation. A small radial or curved incision is then made in the tympanic membrane and a tiny ventilation tube is placed to temporarily replace the eustachian tube to keep the middle ear air pressure balanced, a small tube that does not interfere with the child’s daily life. In addition, if the eustachian tube is malfunctioning due to adenoid hypertrophy, a portion of the hypertrophic proliferators may be removed along with the tube placement to improve the function of the eustachian tube. The results of the surgery can be immediate, as in the case of Ming, who felt a significant improvement in hearing after the surgery and even thought it was “too loud”.