Description

• Insidious condition characterized by accumulation of non purulent effusion in the middle ear cleft without signs of acute infection
• Occurs after an episode of acute otitis media or in the context of Eustachian tube dysfunction
• Young children presenting with hearing problems, often describe sound as muffled associated with aural fullness and with upper respiratory tract infections may be serous otitis media

Types

Symptoms

• The disease usually affects children of 5–8 years of age
• Hearing loss
• Delayed and defective speech
• Mild earaches

Sequelae of chronic secretory otitis media

• Atrophic tympanic membrane and atelectasis of the middle ear
• Ossicular necrosis
• Tympano sclerosis
• Retraction pockets and cholesteatoma

Investigation

Otoscopic findings

• Tympanic membrane is often dull and opaque with loss of light reflex
• Tympanic membrane may show varying degree of retraction
• Fluid level and air bubbles may be seen when fluid is thin and tympanic membrane is transparent

 Hearing tests

• Tuning fork tests show conductive hearing loss
• Audiometry - There is conductive hearing loss of 20–40dB
• Impedance audiometry -reduced compliance and flat curve with a shift to negative side
• X-ray mastoids - There is clouding of air cells due to fluid

Treatments

Medical

• Decongestants
• Anti allergic measures
• Antibiotics

Surgical

• Myringotomy and aspiration of fluid
• Grommet insertion
• Tympanotomy or cortical mastoidectomy

Ayurvedic Treatment

• Management of URTI
• Advice to avoid Cold Items

Internal Medicines

For Associated Respiratory tract infections

• Dashamoola katutraya Kashaya
• Vyoshadi vataka

To relieve infection

• Panchathiktaka kashaya
• Guggulu pancha pala choorna
• Kaisora guggulu
• Mahatikthaka gritha
• Guggulu thikthaka gritha

Procedures

• Kabala - Triphala kashaya + Trikatu choorna
• Ear toileting
• Karnadhoopana - Guggulu varthi / Haridra
• Karnapichu - Surasa rasakriya
• Jaloukavacharana over ear

Department

Salakya - ENT