Diagnosis and treatment of secretory otitis media Main pathogenesis and mechanism. Secretory otitis media is a non-purulent inflammation of the middle ear that is characterized by fluid accumulation in the middle ear and hearing loss, and is confusingly named as plasmacytosis, catarrhal otitis media, or exudative otitis media. At present, it is collectively called secretory otitis media. There are three main causes for its development. (1) Malfunction of the eustachian tube (2) Infection (3) Immune response. The causes of eustachian tube malfunction can be divided into two main categories: mechanical blockage and non-mechanical blockage. The former causes include various occupying lesions in the nasopharynx, such as various tumors, including benign and malignant ones, such as adenoid hypertrophy (more common in children. Nasopharyngeal cancer (more common in adults) and various other tumors. Other causes are chronic rhinitis chronic sinusitis deviated nasal septum, etc.