Secretory otitis media in children

[Raeanne Dimick]

Secretory otitis media is fluid that accumulates behind the eardrum and remains there after an acute middle ear infection or blockage of the eustachian tube.

A previous ear infection is the usual cause, but some children may develop it as a result of a blocked eustachian tube.
Children typically have no pain, but fluid can impair hearing.
Diagnosis involves physical examination of the eardrum and sometimes tympanometry.
Secretory otitis media usually resolves without treatment, but some children need surgery to install a ventilating tube.

Secretory otitis media often occurs after an acute middle ear infection. The fluid that has accumulated behind the eardrum during the acute infection remains after the infection resolves. Secretory otitis media may also occur without a preceding ear infection. It may be due to a blockage of the eustachian tube (the tube that connects the middle ear with the nasal passages) by an infection, enlarged adenoids (collections of lymphoid tissue located where the throat and nasal passages meet), tumors (rarely), or possibly gastroesophageal reflux disease. Allergies (such as seasonal allergies or year-round allergies) may also make secretory otitis media more likely to develop. Secretory otitis media is extremely common among children aged 3 months to 3 years.
(See also Overview of Middle Ear Infections in Young Children and see also Otitis Media (Secretory) in adults.)