Medical management of serous otitis in children

• Published in: Pediatrics (Evanston) 1978-05, Vol.61 (5), p.768-774
• Main Authors: Bierman, C W, Furukawa, C T
• Format: Article
• Language: English
• Subjects: Ear, Middle - immunology; Humans; Otitis Media - diagnosis; Otitis Media - etiology; Otitis Media - immunology; Otitis Media - therapy; Rhinitis, Allergic, Seasonal - complications; Serous Membrane
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.61.5.768

Though pediatricians have long been concerned with the problem of fluid in the middle ear as it pertains to infection or temporary conductive hearing loss, it is only recently that they have begun to be aware of the long-term consequences of middle ear fluid. Brannon and Murray,1 for instance, studied language skills in children with hearing impairments and found deficits in five specific areas including total words, words per sentence, total errors, words per corrected sentence, and syntax score. Nation2 studied children of normal intelligence with cleft palate. Even with the exclusion of children with a hearing loss of 30 dB or greater, he found a significant deficiency of vocabulary comprehension and usage in the children with cleft palates, suggesting that even a mild hearing loss may affect vocabulary development. Holm and Kunze3 studied children with fluctuating hearing loss from chronic otitis media. They found problems of deficient vocabulary, articulation skills, ability to receive and express ideas through spoken language, use of grammar, syntax, and auditory memory skills. Since resolution of serous otitis restores normal hearing, early diagnosis is essenhal to prevent persisting long-term behavioral, social, and educational handicaps. In this article we will focus on changes within the ear, Eustachian tube, and nose which predispose to serous otitis, on methods of diagnosing serous otitis, and on options in management. Serous and Secretory Otitis Media When nonsanguinous middle ear effusions are cultured, approximately one fourth to one third will be sterile4 and will not respond to antibiotic therapy. The pediatrician diagnoses this condition as serous otitis media.