Chronic serous otitis media (often referred as chronic otitis media with effusion) is the most common cause of deafness and hearing loss in early childhood [1] [2] [3]. The pathogenesis involves the accumulation of fluid in the middle ear without damage to the tympanic membrane [2] [4]. The pathogenesis remains unclear, but bacterial microorganisms have been identified in some patients [4]. Nevertheless, an induced production of arachidonic acid metabolites, such as leukotrienes and prostaglandins, could lead to tympanic membrane damage [1].

It was established that up to 80% of all children under 10 years of age will suffer from at least one episode of otitis media with effusion, while the main patient population affected by this ear disorder is aged between 3-7 years [1] [2] [3]. The key manifestation is a bilateral hearing loss that resolves spontaneously, while some children report a tingling sensation [1] [2] [3]. Other symptoms include otalgia and a sensation of pressure in the ear [1] [3].

Acute otitis media (AOM) is often the main precipitating event in young children, whereas an infection of paranasal sinuses seems to be the main risk factor for the development of chronic serous otitis media in the adult population [2] [5]. Although the condition is benign and self-limiting in the majority of cases, many reports have emphasized the risk of inadequate language development in cases of persistent chronic serous otitis media [1] [3]. Furthermore, the vestibular function can be affected as well, producing symptoms such as poor balance and coordination [1] [2] [3].

• Recurrent Upper Respiratory Infection

  All cases of recurrent upper respiratory infections and frequent flare-ups of allergies may induce repeated inflammation and chronic serous otitis media. [ic.steadyhealth.com]

  The incidence of these pathogens are higher in children under the age of 2, and in children with recurrent upper respiratory infections. Investigations: Puretone audiometry: Demonstrates mild to moderate conductive deafness. [drtbalu.co.in]

• Tinnitus

  Learn More About Topic Tinnitus Over 50 million Americans have experienced tinnitus, or ringing in ears, which is the perception of sound without an external source being present. [entnet.org]

  Tinnitus is a condition most commonly known as ringing in the ears, but it can also present as humming, buzzing, or hissing. We are one of the few practices that specializes in tinnitus treatment in Boca Raton, Florida. [labyrinthaudiology.com]

  Meniere’s disease is associated with attacks of vertigo (a sensation of spinning) and/or tinnitus, fullness in the ear and hearing loss. A sensorineural hearing loss is associated with Meniere’s disease and in most cases only one ear is affected. [deafness.org.au]

  Typically caused by a virus and less commonly bacteria, common symptoms include dizziness, vertigo, loss of balance, flickering of the eyes (nystagmus), and tinnitus or hearing loss. Labyrinthitis is classified to subcategory 386.3. [fortherecordmag.com]

• Otalgia

  Other symptoms include otalgia and a sensation of pressure in the ear. [symptoma.com]

  Head and neck symptoms Children may show signs of earache or otalgia through the pulling of the affected ear. [ehealthhall.com]

  In acute otitis media, otalgia is the most common complaint. Other common signs and symptoms include otorrhea, hearing loss, headache, fever, and irritability. [radiopaedia.org]

  The occurrence of subsequent fever, otalgia, and unscheduled medical visits were not significantly different between the groups. Further analysis showed that fever and otalgia were predictors of filling the antibiotic prescription in the WASP group. [raysahelian.com]

  Treatment Strategy for Acute Otitis Media Initial presentation Diagnosis established by physical examination findings and presence of symptoms Treat pain Children six months or older with otorrhea or severe signs or symptoms (moderate or severe otalgia [aafp.org]

• Hearing Problem

  One common symptom of OME is hearing problems. In younger children, behavior changes can be a symptom of hearing problems. For example, a child may turn the television up louder than usual. They may also tug or pull on their ears. [healthline.com]

  Fortunately, despite ear infections being the most common disease of childhood, permanent speech and hearing problems are rare. [entsurgicalillinois.com]

  This review summarizes the studies using antihistamines, decongestants or a combination of antihistamines and decongestants and finds no benefit for any of the short or long-term outcomes including resolution of the fluid, hearing problems or the necessity [cochrane.org]

  In the early stages, SOM causes a hearing problem, but as time goes on, the trapped fluid may become infected with bacteria and cause further complications. [medicalhearingsystems.com]

  Your child may have a hearing test done at that visit, (especially if they are over 2 or have speech or hearing problems); there is a charge for this test as well as any ear plugs or head bands you purchase. [entcentergr.com]

• Ear Discharge

  Chronic Suppurative Otitis Media Chronic Suppurative OM is a result of an episode of an acute OM but is characterized by a persistent ear discharge due to the perforation of the tympanic membrane. [ehealthhall.com]

  Discharge 258 Intravenous Antibiotics for Otorrhea 261 Evaluation and Treatment of Recurrent PostTympanostomy Otorrhea 266 Workup and Management of Chronic Otorrhea 271 MethicillinResistant Staphylococcus aureus Otorrhea 278 [books.google.de]

  In more severe cases the symptoms include hearing loss, earache or pain, dizziness, high fever, ear discharge, nausea and tinnitus. In some cases the eardrum cannot withstand the increasing pressure from the buildup of fluid and tears. [hear-the-world.com]

• Progressive Hearing Loss

  hearing loss due to more spicules. [quizlet.com]

  Otosclerosis causes a progressive hearing loss which usually starts in the mid 30’s. The hearing loss from otosclerosis can be conductive, mixed or sensorineural depending on where the bone growth occurs. [deafness.org.au]

• Tingling

  The key manifestation is a bilateral hearing loss that resolves spontaneously, while some children report a tingling sensation. Other symptoms include otalgia and a sensation of pressure in the ear. [symptoma.com]

Because chronic serous otitis media poses a significant risk for inducing deafness in early childhood, an early diagnosis is of critical importance. The first part of the diagnostic workup should be a thorough patient history during which the course of symptoms, their progression, as well as severity, should be assessed, together with a history of previous ear infections [1] [3]. In the presence of auditory complaints, the physical examination should pay special attention to the inspection of the ear, mainly through otoscopy and otomicroscopy [1] [3]. The initial findings can be retracted tympanic membrane and a shortened malleus, whereas a clear or blue-to-yellow fluid can be observed through the ear drum [3].

In serious cases, hearing testing should be conducted [1]. Conductive hearing loss ranging from 10-50 dB is mainly observed, depending on the amount and viscosity of the fluid [3]. Appropriate therapeutic strategies are designed, based on the severity of hearing loss, ranging from further testing and conservative treatment to surgery [1].

• Immunoglobulin A Increased

  Abstract In characterizing the immunochemical and biochemical nature of middle ear effusions (MEE) of chronic serous otitis media (SOM), we have previously shown that MEE contain all major immunoglobulin classes, increased levels of several lysosomal [ncbi.nlm.nih.gov]

1. American Academy of Family Physicians; American Academy of Otolaryngology-Head and Neck Surgery; American Academy of Pediatrics Subcommittee on Otitis Media With Effusion. Otitis media with effusion. Pediatrics. 2004;113(5):1412-1429.
2. Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M. Update on otitis media – prevention and treatment. Infect Drug Resist. 2014;7:15-24.
3. Minovi A, Dazert S. Diseases of the middle ear in childhood. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2014;13:Doc11.
4. van Zon A, van der Heijden GJ, van Dongen TM, Burton MJ, Schilder AG. Antibiotics for otitis media with effusion in children [review] Cochrane Database Syst Rev. 2012;9: CD009163.
5. Finkelstein Y, Ophir D, Talmi YP, Shabtai A, Strauss M, Zohar Y. Adult onset otitis media with effusion. Arch Otolaryngol Head Neck Surg. 1994;120(5):517–527.