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].

• Surgical Procedure

  Intradermal skin testing was done by the Rinkel technique under general anesthesia in conjunction with myringotomy and associated surgical procedures. [ncbi.nlm.nih.gov]

  This surgical procedure involves making a small opening in the eardrum to drain the fluid and relieve the pressure from the middle ear. [chop.edu]

  Surgery If the ear infection did not respond to the treatment or is recurring, a surgical procedure may be advised by the physician. [ehealthhall.com]

  Surgical There is a paucity of up-to-date evidence of surgical procedures for CSOM [ 13 ]. [patient.info]

  If your child continues to suffer infections despite antibiotic treatment, the doctor may recommend a surgical procedure to place tubes in your child’s ears, allowing air to flow into the middle ear and prevent fluid buildup in the middle ear. [medicalhearingsystems.com]

• Weight Loss

  Causes of patulous Eustachian tube may include weight loss, pregnancy, stress, hormone fluctuations, anxiety, and temporomandibular joint (TMJ) problems. [medicalhearingsystems.com]

• Rhinitis

  There is increasing evidence to suggest that allergic rhinitis and otitis media coexsist. It has been reported that up to 30-45% of patients with allergic rhinitis have otitis media. [bmj.com]

  In the majority of cases, the cause is related to dysfunction of the eustachian tube due to viral or bacterial rhinitis and occasionally to nasopharyngeal tumors. [ncbi.nlm.nih.gov]

  J301Allergic rhinitis due to pollen J302Other seasonal allergic rhinitis J305Allergic rhinitis due to food J3081Allergic rhinitis due to animal (cat) (dog) hair and dander J3089Other allergic rhinitis J309Allergic rhinitis, unspecified J310Chronic rhinitis [cms.gov]

  Allergic rhinitis in children is one of the approved indications for Montelukast. Montelukast's effect on OME has been studied in several previous studies. [clinicaltrials.gov]

• Overeating

  However, their use has diminished over the years because of concerns over the production of bacterial resistance to the antibiotics. View Abstract Ear tubes have been shown to be effective in the prevention of recurrent acute otitis media. [entusa.com]

  All cases had adequate conservative medical and surgical treatment over a period of years for chronic serous otitis before mastoidectomy wa considered. [ncbi.nlm.nih.gov]

  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]

  Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals. [aapc.com]

• Skin Rash

  For every 14 children treated with antibiotics, one child has an episode of either vomiting, diarrhea or a rash. [11] If pain is present, pain medications may be used. [en.wikipedia.org]

• Tinnitus

  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]

  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]

  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]

• Hearing Impairment

  A disturbance in the inner ear fluids or nerve endings may result in a sensorineural hearing impairment. Most often this type of hearing impairment is due to a hair cell loss. This type of impairment is not correctable with surgery. [potomacaudiology.com]

  A disturbance in the inner ear fluid or nerve endings may result in a sensorineural (nerve) hearing impairment. This type of impairment is not correctable. [pedja5.tripod.com]

  One of potential complications is hearing impairment. Serous Otitis Media: Causes Problems with Eustachian tube opening may be congenital or acquired. [ic.steadyhealth.com]

  Poorly controlled allergic rhinitis can lead to chronic otitis media, chronic sinusitis and hearing impairment. [bmj.com]

  Chronic otitis media with effusion is a common problem in children that sometimes causes hearing impairment which may affect language development and quality of life of the child. The standard treatment is surgical insertion of ventilation tubes. [clinicaltrials.gov]

• Otalgia

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

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

  It is also important to document your child's hearing with a formal hearing test. 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

  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]

  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]

  The typical signs to watch for include: Tugging or pulling at the ear(s) Loss of appetite Unsettledness and crying Trouble sleeping High fever Discharge from the ears Problems with balance Trouble hearing, especially soft sounds or when being spoken to [hear-the-world.com]

• 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].

• Streptococcus Pneumoniae

  Amoxicillin had the highest ratio of mean peak concentration in MEF to minimal inhibitory concentration (MIC) for the three most common pathogens of otitis media (Streptococcus pneumoniae, ampicillin-sensitive Haemophilus influenzae, and Streptococcus [ncbi.nlm.nih.gov]

  Definition / general Acute or chronic infectious disease of middle ear Usually childhood disease caused by Streptococcus pneumoniae or Haemophilus influenzae ( Pediatr Infect Dis J 2004;23:1142 ); also coinfection by viruses ( Clin Infect Dis 2006;43: [pathologyoutlines.com]

  It is the pathogen Streptococcus pneumoniae that is considered to be the primary cause of OM. This organism, along with Moraxella catarrhalis and Haemophilus influenza make up around 95% of all OM cases [1, 2]. [ehealthhall.com]

  Etio-Pathology Bacteriology  Streptococcus Pneumonia  Haemophilus Influenzae  Branhamella Catarrhalis  The incidence of pathogens was higher in the younger children 7. [slideshare.net]

  Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the most common organisms isolated from middle ear fluid. Management of acute otitis media should begin with adequate analgesia. [aafp.org]

• Staphylococcus Aureus

  Antibiotics should have activity against Gram-negative organisms, particularly pseudomonas and Gram-positive organisms, especially Staphylococcus aureus: Aminoglycosides and the flouroquinolones both meet these criteria but there remain safety concerns [patient.info]

  aureus, gram-negative enteric bacteria, and anaerobes. [emedicine.medscape.com]

  Acute otitis media [ edit ] The most common bacteria isolated from the middle ear in AOM are Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, [16] and Staphylococcus aureus. [24] Otitis media with effusion [ edit ] Otitis media [en.wikipedia.org]

Ear tube placement should be considered in the treatment of long standing ear fluid. View Abstract An adenoidectomy has been shown to be effective in the treatment of serous otitis media. [entusa.com]

Serous Otitis Media: Treatment Treatment for acute serous otitis media includes treatment of the underlying conditions that have led to inflammation of the middle ear. [ic.steadyhealth.com]

Appropriate therapeutic strategies are designed, based on the severity of hearing loss, ranging from further testing and conservative treatment to surgery. [symptoma.com]

Treatment of Acute Serous Otitis Media Treatment of acute serous otitis media is medical and is directed towards treatment of the upper respiratory infection or allergy attacks. [pthearingcenter.com]

After the testing and evaluation, we will share our initial diagnosis and discuss treatment options, so you can make an informed decision concerning your treatment plan. [labyrinthaudiology.com]

[…] adequate treatment Tympanosclerosis Scarring of the tympanic membrane due to recurrent ear infections or otitis media with effusion May be asymptomatic or lead to conductive hearing loss White calcified plaques in the tympanic membrane seen on otoscopy Prognosis [amboss.com]

Intratemporal complications include: Petrositis Facial paralysis [ 17 ] Labyrinthitis Intracranial complications include: Lateral sinus thrombophlebitis Meningitis Intracranial abscess Sequelae include: Hearing loss Tympanosclerosis Prognosis [ 2 ] Prognosis [patient.info]

Prognosis Otitis media with effusion (OME) is the leading cause of hearing loss in children. [emedicine.medscape.com]

Inclusion of steroids in the drops improves prognosis. (Roland et al. 2003) Uncommon treatments: Steroids -- oral, nasal and injected steroids are occasionally used but their use is presently controversial. [dizziness-and-balance.com]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Chronic suppurative otitis media Definition : persistent drainage from the middle ear through a perforated tympanic membrane lasting > 6–12 weeks Epidemiology : most common in children and adolescents > 15 years old Etiology : bacterial infection following [amboss.com]

The etiologies of the rest of the cases were acute sinusitis, gastroenteritis, parvovirus, serous otitis media, or influenza. [medical-dictionary.thefreedictionary.com]

Figure showing the areas lined by respiratory type of epithelium Etiology: 1. In many children otitis media with effusion is preceded by an episode of acute otitis media. This is common in children who is more prone for upper respiratory infections. [drtbalu.co.in]

OM is the general term that is used for the infection regardless of the etiology. There are different types of OM depending on the presenting signs and symptoms. Figure 1 shows what happen to the ear with an otitis media [1, 2]. [ehealthhall.com]

Chronic suppurative otitis media Definition : persistent drainage from the middle ear through a perforated tympanic membrane lasting > 6–12 weeks Epidemiology : most common in children and adolescents > 15 years old Etiology : bacterial infection following [amboss.com]

Environmental factors Besides the actual pathogens, environmental factors have been shown in numerous epidemiologic studies to be strongly associated with increased prevalence of otitis media with effusion. [emedicine.medscape.com]

Epidemiology and natural history of secretory otitis. Am J Otol. 1984;5(6):459–462. ... 2. Burrows HL, Blackwood RA, Cooke JM, et al.; Otitis Media Guideline Team. University of Michigan Health System otitis media guideline. [aafp.org]

Epidemiology [ 1 ] In Britain, 0.9% of children and 0.5% of adults have CSOM, with no difference between the sexes. [patient.info]

Army: The Aeromedical Epidemiological Data Repository (AEDR) catalogs all Army flight physicals since 1960. There have been approximately 160,000 individual aircrew entered in this database. [asams.org]

[…] the tympanic cavity in the absence of infection lasting for > 3 months Epidemiology : : observed particularly in toddlers after an episode of acute OM Etiology : incompletely understood, but primarily thought to be due to eustachian tube dysfunction Pathophysiology [amboss.com]

Historically, the pathophysiology of OM has always been linked with abnormalities of ET function. As previously reviewed, the ET performs the three classic functions of aeration, clearance, and protection of the middle ear. [asams.org]

Pathophysiology Otitis media with effusion (OME) can occur during the resolution of acute otitis media (AOM) once the acute inflammation has resolved. [emedicine.medscape.com]

View Abstract Ear tubes have been shown to be effective in the prevention of recurrent acute otitis media. In many studies, their effectiveness exceeded prophylactic antibiotics. [entusa.com]

Be attentive to a runny nose and prevent otitis media Prevention and treatment There is little scientific evidence that any specific measures are able to prevent otitis media. [hear-the-world.com]

Removing the adenoids can also help treat or prevent OME in some children. When adenoids become enlarged they can block ear drainage. [healthline.com]

[…] of Acute Otitis Media 134 Mucosal Immunity and Nasal Immunization in the Treatment of Infectious Diseases of the Upper Respiratory Tract 138 Allergy TestingTreatment for Otitis Media 146 Prevention of Acute Otitis Media during the Common Cold 152 Rhinosinusitis [books.google.de]

When this tube is not working properly, it prevents normal drainage of fluid from the middle ear, causing a build up of fluid behind the eardrum. [chop.edu]

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.