Ear

Serous Otitis Media

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Serous Otitis Media, Non-suppurative Otitis Media, Mucoid Otitis Media, Otitis Media with Effusion, Secretory Otitis Media, Glue Ear, Acute Serous Otitis Media, Chronic Serous Otitis Media, Chronic Otitis Media with Effusion

  • Definition
  1. Retention of transudate fluid in middle ear
  • Signs
  1. Dull grey, amber or red TM
  2. Bubbles or air fluid levels
  3. TM retracted and moves to negative pressure (Eustachian Tube Dysfunction)
  4. TM thickened and increased vascularity to opaque
  5. Hearing Loss (<30 DB)
  6. Images
    1. EntSerousOtitisMedia.jpg
  1. At 2 weeks: 70% have persistent effusion
  2. At 4 weeks: 40%
  3. At 2 months: 20%
  4. At 3 months: 10%
  • Management
  1. Otolaryngology referral indications
    1. Persistent serous effusion >3 months
    2. Adhesive Otitis Media signs
  2. Myringotomy and Tympanostomy Tube placement Indications
    1. See Tympanostomy Tube for indications
    2. Consider after 3 months of persistent effusion
  3. Measures shown to be not efficacious
    1. Avoid Decongestants
    2. Avoid Antihistamines
    3. Avoid antibiotics
    4. Avoid Systemic Corticosteroids
      1. Butler (2001) Arch Pediatr Adolesc Med 155:641-7 [PubMed]
      2. Mandel (2002) Pediatrics 110:1071-80 [PubMed]
  4. Consider Intranasal Corticosteroids if comorbid Allergic Rhinitis
    1. (2012) Presc Lett 19(2): 9
  • Complications
  1. Adhesive Otitis Media
  • References
  1. Harmes (2013) Am Fam Physician 88(7):435-40 [PubMed]
  2. Lieberthal (2013) Pediatrics 131(3): e964-99 [PubMed]