Secretory otitis media, also called exudative otitis media, is a non-suppurative disease of the middle ear characterized by fluid accumulation in the middle ear (including plasma and mucus) and hearing loss, and is a common and frequent otologic disease. It is now believed that its occurrence may be related to eustachian tube dysfunction, infection, immune response, etc. Due to their special physiological structure, the diameter of the eustachian tube is only 1/2 of that of adults, and the tympanic orifice is horizontal to the pharyngeal orifice, and the immune system is not yet well developed, children are more prone to develop secretory otitis media than adults. When suffering from secretory otitis media, there can be no symptoms and no hearing loss in the early stages, but as the disease progresses it can cause conductive deafness and some hearing loss. Some parents bring their children to the hospital, saying that their children always turn up the sound when watching TV, or that they can’t hear when they call out to them, or that they can’t hear each other. It is only when they take their child to the hospital for a checkup that they find out that it is “secretory otitis media” that is causing the problem. Most patients with otitis media can recover their hearing quickly if they receive timely treatment, but some patients miss the best time for treatment because they are not detected in time, leaving the middle ear in a constant state of negative pressure, followed by sclerosis or adhesions in the middle ear, which can even cause permanent hearing loss and have a serious impact on the lifelong life of the affected child. Therefore, early detection, early diagnosis and early treatment are very important. So, how can children with secretory otitis media be detected early? When parents or teachers find that their child is unresponsive to sound or has high-risk factors for secretory otitis media, such as nasal congestion, snoring, adenoid hypertrophy, or frequent colds, it is best to take the child to an otolaryngologist and ask a professional doctor to rule out “secretory otitis media” through physical examination, otoscopy, and acoustic conductance testing. It is best to take your child to an ENT specialist to rule out the possibility of “secretory otitis media” through physical examination, otoscopy and acoustic conductance testing. Acoustic conductance testing is easy and non-invasive, and is currently the routine method for diagnosing pediatric secretory otitis media. In addition, in children with adenoid hypertrophy, the obstruction of the posterior nostrils can cause complications due to the compression of the eustachian tube, and it is now believed that adenoid hypertrophy is an important cause of secretory otitis media in children. Once the diagnosis of “secretory otitis media” is confirmed, for some cases of secretory otitis media that are not accompanied by ear symptoms such as hearing loss, since they are often self-healing, they can be observed for 3 months, but attention should be paid to the review of the tympanic membrane and acoustic impedance during this period to determine whether treatment is needed. For patients with otitis media with hearing loss, they need to be treated conservatively with medication for 3 months under the guidance of a doctor. The repeated attacks of otitis media can easily become permanent hearing damage, causing lifelong regrets.