It is the most common disease of children’s ear, nose and throat, causing hearing loss and affecting speech and language development, and should be treated with high vigilance and timely observation. It is the most common disease of children’s ear, nose and throat, which can cause hearing loss and affect speech and language development, and should be observed and treated promptly. Secretory otitis media is a non-purulent inflammatory disease of the middle ear characterized by fluid accumulation in the middle ear and hearing loss. Clinically, it also has different names such as exudative otitis media, non-purulent otitis media, mucus otitis media, catarrhal otitis media, tympanic effusion, plasmacytosis, plasmacytosis-mucus otitis media and aseptic otitis media. Secretory otitis media has a high incidence during childhood development and is the most common disease of the ear, nose and throat in children. It can cause hearing loss and affect speech and language development in children and should be treated with high vigilance and timely observation. Secretory otitis media mostly appears after upper respiratory tract infections, with ear stuffiness and hearing loss as the main symptoms. Since the onset of symptoms is relatively insidious, most of them are not obvious except for partial hearing loss and other symptoms such as ear pain, and children often have unclear complaints due to the reason of expression and communication, so they are often not easily detected by parents and ignored. When suffering from secretory otitis media, infants and children often do not exhibit any behavioral abnormalities. Preschoolers most often ignore their parents’ calls, but parents often mistake this for inattention and ignore it. In school-age children, the main manifestation is inability to hear the lecture during class and watching TV at a high volume. It is only when their hearing is significantly affected that parents notice the abnormality and bring their children to the doctor, but by then the diagnosis and treatment are already delayed. The vulnerability of children to otitis media is related to the special anatomical structure of the nasopharynx and its developmental process. Compared to mature adults, the nasopharyngeal canal is relatively short, wide and straight, so nasopharyngeal secretions can easily enter the middle ear via the eustachian tube and cause inflammation. If a newborn baby is not nursed properly, especially if he or she is bottle-fed in a flat supine position, the milk will accumulate in the nasopharyngeal cavity and enter the middle ear via the eustachian tube, causing otitis media. The clinical manifestation of secretory otitis media is mainly hearing loss. The resulting complaints are mostly stuffy and occlusive sensations in the ear, tinnitus, and the sound of water can be heard by shaking the head, which may vary with position changes. A small number of people may have mild ear pain. Specialist otologic examination reveals an invaginated tympanic membrane with reduced mobility, amber or darkened tympanic membrane, and sometimes planes of air and fluid or bubbles. A typical audiogram shows conductive deafness with the presence of air and bone conduction differences, and a B-shaped tympanic chamber pressure map. If parents pay attention, they can find that infants and children often show poor response to peripheral sounds, inability to turn their heads accurately to the sound source, repeated ear scratching, and irritability. Even if the child does not complain of hearing loss, the family may notice inattentiveness, changes in behavior, poor or no response to normal conversation, and always turning up the sound when watching TV or using hearing devices. If parents find that the child has the above abnormalities, they should go to the hospital as soon as possible. The doctor can make a clear diagnosis based on the medical history and specialized examination, combined with tympanic chamber conductivity map and acoustic reflex, ear microscopy or endoscopy, etc. Secretory otitis media in infants and children should be distinguished from acute otitis media. Inadequate treatment of acute otitis media can lead to otitis media with secretion. Acute otitis media has an acute onset and a short duration. Patients may have severe ear pain, and after the ear pain is relieved or disappears, symptoms such as pus flowing from the ear may appear, which may be accompanied by systemic symptoms such as fever and mental discomfort. In the case of otitis media, the duration of the disease is longer and the main symptom is stuffy ears, and the ear pain is not obvious, or even no ear pain at all. Secretory otitis media has a certain rate of self-healing, and the rate of self-healing is even higher in infants and children. Children should be closely monitored and followed up before invasive treatment is given, and conservative treatment should be given for at least 3 months. For non-risk children, a period of observation and follow-up is not harmful and parents should be informed that the child should be reviewed periodically, and otoscopy and tympanogram should be performed during the review. In the case of untreated secretory otitis media, timely treatment is necessary, otherwise permanent conductive deafness or sensorineural deafness may result. If conservative treatment is not effective, treatments such as aspiration of fluid in the tympanic chamber and tympanic membrane placement can be used. It is also important to pay attention to the treatment of the causes of secretory otitis media, such as adenoid hypertrophy, nasal polyps, and nasopharyngeal tumors.