Secretory otitis media – a common disease affecting hearing Secretory otitis media is a common disease in otolaryngology, characterized by fluid accumulation in the middle ear and hearing loss, mostly secondary to acute otitis media. According to statistics, 70% of children younger than 3 years old have had otitis media, and 90% of children younger than 7 years old have had at least one otitis media. Clinically, secretory otitis media is more common in children, but there are also many cases in adults. It often occurs after upper respiratory infections, air travel, and in some cases due to sinusitis and nasopharyngeal tumors. After the occurrence of secretory otitis media, the function of the eustachian tube will be further affected, and the air in the middle ear will not be replenished after being absorbed into the bloodstream, resulting in negative pressure in the middle ear, which in turn will aggravate the secretory otitis media, creating a vicious circle. If the disease can be diagnosed early, the treatment effect is better. The main treatment measures include the following: First, if the patient has a stuffy and runny nose, nasal drops such as ephedrine should be used to improve nasal ventilation. However, if the patient does not have these symptoms, do not use ephedra-based drugs to avoid unnecessary side effects. Oral antimicrobials and antipyretics for upper respiratory tract infections and inflammation. Oral phlegmolytic drugs to improve the breakdown and drainage of nasal and middle ear secretions. If the patient has nasal polyps or sinusitis, cure them early. Second, do pharyngeal tube blowing, which is simply done by inhaling and then pursing the mouth and pinching the nose and drumming to let air into the ear. Some hospitals have pharyngeal bulb or catheter blowing. Third, tympanic membrane puncture. Tympanic membrane puncture can extract fluid from the middle ear and also inject air to quickly improve the pressure state of the middle ear, and the puncture site will usually heal quickly. Multiple punctures are possible. Fourth, if tympanic membrane puncture is ineffective, a tympanic ventilation tube can be placed. If the child has adenoid hypertrophy, this can be removed as well. The tympanic ventilation tube can be placed for several months, in children, until the age of few upper respiratory infections, or 7-8 years. In adults, the decision can be made on an individual basis in consultation with a physician. If the ventilation tube comes out on its own and the condition does not heal, it can be reinserted. During the time the tube is in place, care should be taken that no water enters the ear canal, as this can cause middle ear infections. For children with secretory otitis media, you can take oral antimicrobials for 7-10 days early, and take drugs for upper respiratory tract inflammation and phlegm, repeat pinching and puffing, or pharyngeal tube blowing and more swallowing movements, observe for 3 months, 90% of patients can be cured, 10% of patients can consider placing tympanic ventilation tubes, usually children need to be hospitalized under general anesthesia for placement. In adults with secretory otitis media, the placement of tympanic ventilation tubes can be considered after several ineffective blowing of the eustachian tube or tympanic membrane puncture, which can usually be done with outpatient local anesthesia. According to the causes of this disease, prevention of colds and timely treatment of upper respiratory tract infections and keeping the nasal passages open are the keys to prevention of this disease. Strengthening health promotion and raising parents’ awareness of the disease can help in the early detection of secretory otitis media in children. For unilateral secretory otitis media in adults, it is important to be alert to nasopharyngeal lesions.