Shahe Din, Arif Raza Khan, Noor Sahib Khan, Fazle Sattar, Abdullah Jan.
Management of secretory otitis media in children.
J Postgrad Med Inst Jan ;19(1):106-10.

Objective: The purpose of this study was to know the different treatment options for otitis media with effusion. Material and Methods: This descriptive study conducted at Khyber Teaching Hospital Peshawar Pakistan from June 2003 to June 2004. Only the diagnosed cases of secretory otitis media were included in the study. After taking history and thorough clinical examination, routine investigations and special investigations such as pure tone audiometry and tympanometry were carried out to assess the severity of hearing loss and to confirm the diagnosis of secretory otitis media. All patients were initially treated by systemic antibiotics, whereas in cases not responding to systemic antibiotics in two weeks time, tympanostomy tubes with adenotonsillectomy was offered. The follow up of cases was carried out from 6 months to 12 months. Results: The most common presenting symptom was conductive deafness in 27 patients (90%). The most common aetiological factor was hypertrophied adenoids in 25 cases (83.3%). All patients were initially treated by systemic antibiotics, mucolytics, nasal decongestants alone. Whereas in 20 cases (66.7%) after giving systemic antibiotics for a period of 2 weeks, when symptoms did not subside, then the patients were offered tympanostomy tubes with adenotonsillectomy. In this group the patients improved in hearing and feeling of blocked ears. Conclusion: The children with secretory otitis media with effusion should have a course of systemic antibiotics; if effusion persists then surgical intervention in the form of myringotomy with or without grommet (tympanostomy tube) is advised.

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