Secretory otitis media (OME) is a non-suppurative inflammatory disease of the middle ear characterized by fluid accumulation in the middle ear (including plasma, mucus, and plasma-mucus) and hearing loss, without signs and symptoms of acute infection of the tympanic cavity and mastoid process. Hearing loss is caused by persistent fluid accumulation in the middle ear cavity that affects the dynamics of the tympanic membrane and forms a barrier to sound transmission. The prevalence is high in children, and epidemiological surveys abroad have found that approximately 90% of preschoolers have had OME, most commonly in children 6 months to 4 years of age, and 25% of school-age children have OME, the vast majority of which can subside on its own. By the age of 6 to 7 years, its incidence decreases significantly as the eustachian tube normalizes its function. It is one of the most important diseases causing hearing loss in pediatric patients. Children, especially infants, have a high rate of misdiagnosis due to lack of complaints, combined with a narrower external auditory canal, collapse, tilted tympanic membrane, thicker than adults and lack of cooperation in physical examination. The diagnosis is made based on clinical symptoms, signs and auxiliary examinations. It often presents with intermittent mild ear pain, ear discomfort and a feeling of ear stuffiness. Younger infants and children may have recurrent ear scratching, irritability, and restless sleep. Due to the effects of OME on hearing, affected children may be unresponsive to everyday conversations or environmental sounds, ignore parental calls, be distracted, have learning disabilities, and in some cases, even have balance disorders and speech and language development disorders. The “gold standard” for detecting middle ear effusion is a thin CT scan of the ear with tympanic membrane puncture, but it is difficult to be accepted by parents and is not used as a routine diagnostic procedure. The recommended method for OME is rigid otoscopy, which provides clear illumination and allows direct and comprehensive observation of the tympanic membrane color, invagination or convexity and tympanic fluid accumulation. The duration of the disease is greater than 3 months and the hearing level in the better ear is 40 dB or worse; recurrent OME with adenoid hypertrophy should be treated surgically; tympanic tube placement is the preferred surgical procedure. Tympanic tube placement maintains long-term air pressure balance, reduces the proliferation of cupped cells and glands, prevents excessive fluid production, and indirectly promotes the restoration of cilia movement, allowing time for improvement of eustachian tube function. Adenoidectomy combined with tympanotomy can also achieve good results in children over 4 years of age.