Abstract
The removal of an accumulation of nonpurulent fluid in the middle ear is a common otologic problem. There is no doubt that in the great majority of cases of catarrhal otitis media the condition resolves spontaneously or responds to simple therapeutic management. This paper is primarily concerned, however, with the occasional recalcitrant case in which accumulated fluid presents a stubborn front to all the various remedies at the disposal of the otologist. In these difficult cases the fluid is apparently incompletely removed or accumulates more rapidly than it is emptied. Permanent evacuation of all excess fluid is necessary in order to avoid secondary degenerative changes. These possible alterations include chronic fibrous narrowing of the eustachian tube, permanent retraction of the membrana tympani, with or without adhesions to the promontory, and varying degrees of impairment of hearing commonly described as chronic catarrhal deafness. DIAGNOSIS OF FLUID IN THE MIDDLE EAR The
Published Version
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