Management of secretory otitis media: a prospective randomised study comparing medical management with early surgical intervention

Abstract

<p class="abstract"><strong>Background:</strong> Secretory otitis media is the most common cause of conductive hearing loss in children. Though self-limiting recurrent disease can cause speech and language delay, cognitive impairment and behavioural problems in the long term. This is a prospective study of the epidemiological profile, predisposing factors, clinical profile of secretory otitis media. This study also compares the conservative treatment with early surgical Treatment in Patient with secretory otitis media.</p><p class="abstract"><strong>Methods:</strong> The study is a prospective randomised study of patients presenting with conductive hearing loss diagnosed by pure tone audiometry. The patients were randomized into two groups of 25 patients each. The medical management arm received antihistamines and decongestants and the surgical arm patient underwent myringotomy with grommet insertion. Patients with adenoid hypertrophy underwent adenoidectomy as an additional procedure. The patients were followed up regularly and where evaluated at the end of 12 months for symptomatic improvement and hearing improvement by Pure Tone Audiogram and impedance audiogram. </p><p class="abstract"><strong>Results:</strong> The most common age group affected was between 5-15 yrs with hard of hearing and aural fullness being the most common presenting complaint. Eustachian tube dysfunction with adenoid hypertrophy was the most common precipitating factor (68%) followed by allergy and gastro esophageal reflux disease. Compared to medical treatment which resulted in a successful treatment outcome in 40% of patients, cases which underwent surgical treatment had successful outcome in 70% of cases.</p><p class="abstract"><strong>Conclusions:</strong> Surgical management in the form of adenoidectomy/myringotomy with grommet insertion has better long term outcome in terms of hearing impairment and disease relapse and recurrence.</p>