I. Invisible killer of children’s hearing health, secretory otitis media A large number of evidence-based medical studies at home and abroad have found that the incidence of otitis media in infants and children is quite high, mainly secretory otitis media, with a cumulative incidence of about 35% to 85% for the first attack of secretory otitis media in children at 6 months of age and about 50% to 96% at 1 year of age, and a high recurrence rate. Persistent secretory otitis media can cause hearing impairment in children, especially during the formative years of speech (2-5 years), and can cause language development disorders with increasing impact on the physical and and psychological development of children. Most cases of otitis media have an insidious onset and the main symptoms are: hearing loss, ear pain, tinnitus, a feeling of stuffiness or stuffiness in the ear. In addition, most cases have a history of upper respiratory tract infection before the onset, often accompanied by nasal congestion, runny nose, sore throat or cough. After examination and diagnosis, the following principles should be followed for treatment: removal of middle ear fluid, improvement of middle ear ventilation and drainage, and treatment of the cause of the disease. If untreated or left untreated for a long time, the lesion will aggravate and affect the tympanic chamber, an important structure in the room, forming glue ear and adhesive otitis media, which can even cause inner ear lesions leading to sensorineural deafness, and then the treatment will be tricky and less effective. Therefore, it is important to achieve early detection, early diagnosis and early treatment to return a healthy hearing world to children. The relationship between adenoids and secretory otitis media, an important aspect of treatment that cannot be ignored Factors related to the development of secretory otitis media include adenoid hypertrophy, tonsillar hypertrophy, obstructive sleep apnea syndrome, allergic reactions, obesity, etc., of which adenoid hypertrophy is the most common disease in children. There are various theories of adenoidal hypertrophy factors causing secretory otitis media, including mechanical obstruction theory, inflammation theory, infection theory, etc. If secretory otitis media persists for more than 3 months with hearing loss and other symptoms, or if long-term secretory otitis media presents with ear pain, unexplained sleep disturbance and recurrent acute otitis media, surgical treatment, such as tympanotomy or tympanotomy tube placement, should be considered. However, the adenoids must be examined before surgery, and the options are lateral nasopharyngeal x-ray, nasopharyngeal CT or electronic nasopharyngoscopy. Adenoids can often be seen to occupy the entire nasopharynx, blocking the posterior nostril and compressing the pharyngeal orifice of the eustachian tube, affecting its physiological function. Sometimes the adenoids cannot be ignored even when imaging reports that they are not large. In some cases, such as a colleague’s child, monaural morbidity was always treated for a period of time without significant improvement, and an electronic nasopharyngoscopic examination of the adenoids revealed that although the adenoids were not very large, the adenoid tissue on the ipsilateral side of the affected ear was clearly compressing the pharyngeal orifice of the eustachian tube, which is not reflected on a lateral nasopharyngeal X-ray, and if a nasopharyngeal CT is done, the diagnosis can be missed without careful reading of the CT because it may only Therefore, if the child is cooperative, it is recommended to do an electronic nasopharyngoscopy to see the adenoids directly and also to see if there is pus flowing down the posterior nostril to help diagnose sinusitis.