Pediatric secretory otitis media is a common disease in otology and a persistent condition that is difficult to diagnose at an early stage and difficult to treat at a late stage. Domestic statistics show that secretory otitis media accounts for 2.28%-4.96% of outpatients in otolaryngology; the incidence of otitis media in primary and secondary school students is 4%-18%. The common causes of secretory otitis media in children are: 1. the low, flat position of the eustachian tube in children, the short, thick lumen of the tube, and the tendency to choke and cough when sucking breast milk in the prone position, causing milk to accidentally enter the middle ear; 2. the cartilaginous part of the eustachian tube is tender and cannot open on its own; 3. the immune system of the middle ear is not yet well developed; 4. the tonsils become edematous and hyperplastic after infection, easily blocking the pharyngeal opening of the eustachian tube; 5. the presence of bacteria and viruses in the adenoids can directly or indirectly cause middle ear infection; 6. 6. Inadequate development of the mastoid air chamber and insufficient air reserves; 7. Children under 2 years of age often have interstitial or internal bud tissue that block the Eustachian tube in a live valve pattern; 8. Children are prone to nasal and upper respiratory tract diseases that affect the function of the eustachian tube; 9. Children’s central nervous system is at a developmental stage, with poor regulatory function and low immunity, and are prone to upper respiratory tract diseases. The causes of secretory otitis media are mainly caused by poor function of the eustachian tube, infection, and allergic and immune reactions. The eustachian tube is the only channel between the middle ear and the outside world through the nasopharynx and has the function of regulating the air pressure within the tympanic chamber, maintaining the balance of air pressure with the outside world, cleaning defense and sound prevention. These physiological functions are accomplished by opening the eustachian tube once every minute during wakefulness and once every 5 minutes during sleep. If there is no swallowing for one hour or if the eustachian tube is closed for one hour, a negative pressure of 15-20 mmHg will occur in the middle ear. Due to lesions of the eustachian tube itself or surrounding organs, its regulatory function becomes impaired, the gas in the middle ear cavity is absorbed and negative pressure is formed, the veins in the mucosa of the middle ear cavity expand, the permeability of the tube wall increases, and serum leaks or exudes and accumulates in the middle ear, which forms secretory otitis media. Patients with secretory otitis media often develop the disease after a cold combined with an upper respiratory tract infection, and the local examination mostly shows congestion of the tympanic membrane, which is cloudy and hairy and loses its normal luster. The tympanic membrane is often yellowish, orange-red, amber, milky white or grayish after the accumulation of fluid in the tympanic chamber. When there is a lot of fluid accumulation, the tympanic membrane can be seen to have a plane of fluid with the concave surface upward, and sometimes bubbles can be seen. When there is a lot of fluid, the tympanic membrane is protruding and movement is limited, and fluid can be extracted by tympanic membrane puncture. It is not difficult to diagnose in children. We hope that parents will pay attention to the following aspects, which can help in the diagnosis. In the acute stage, the main manifestations are ear pain and later manifestations: 1. unable to accurately say or point out the source of the sound, and the head is often turned in the wrong direction when called; 2. often do not respond to general conversation, and must use loud or tap on the back of the shoulder to attract attention; 3. often ask “what” when talking with others and need to repeat; 4. in a noisy environment 5. often do not listen, do not pay attention or ignore others; 6. often sit close to watch TV or turn up the volume of TV; 7. prefer to act alone and do not want to participate in group activities; 8. cannot correctly follow several aspects of verbal instructions one by one, or hesitate to perform; 9. gradually increase the tone of voice during speech or reading aloud. Acoustic conduction resistance examination is of great value in the diagnosis of pediatric secretory otitis media. The principles of treatment for secretory otitis media are: to remove fluid from the middle ear cavity, to restore the function of the eustachian tube, and to remove the etiological lesions. In pediatric patients, the foci are mainly adenoid hypertrophy and turbinate hypertrophy. By removing the adenoid and reducing the hypertrophy of turbinate, the function of the eustachian tube is restored and the purpose of treating pediatric secretory otitis media is achieved.