• Mohammad Yousaf
  • Inayatullah Inayatullah
  • Farida Khan


Background: Otitis media with effusion (OME) is a leading cause of hearing difficulty in children.OME must be detected early and managed properly to prevent hearing and speech impairment inchildren. This study was aimed to compare results of medical and surgical treatments in terms ofhearing improvement, recurrence of Middle Ear Effusion (MEE), time to offer surgical intervention.Methods: The study was conducted from June 2008 to December 2011. A performa was used tocollect data. Every child having hearing difficulty was examined with pneumatic otoscope for fluidlevel and tympanic membrane mobility. These children were investigated with pure tone audiometryfor level of hearing loss and tympanometry to confirm the middle ear effusion. X-Ray nasopharynxlateral view was taken to see if there were adenoids. All patients were treated conservatively in the firstphase. Those not responding to conservative treatment were treated with myringotomy andadenoidectomy with or without ventilation tubes. Patients were followed-up for up to 36 months.Results: Middle ear effusion cleared in 80 (71.5%) out of 112 ears. No improvement was noted in 32ears for 9 months. Resistant and recurrent cases were managed with adenoidectomy and myringotomyalone or with insertion of ventilation tubes (VT). Recurrence was noted more common withmyringotomy alone than with ventilation tubes. Medical treatment failed in 32 ears. MEE recurred in 9ears. VT was put in 41 ears. The hearing level improved with VT by 10–15 dB after first 3 months.Conclusion: All children with OME should be treated conservatively. It is cost effective and relievesMEE in about 70% of patients. The ears with OME that fails to resolve or recur should be managedwith myringotomy and VT insertion or adenoidectomy.Keywords: otitis media with effusion, myringotomy, adenoids; rhinosinusitis, tympanometry


Paparella MM, Jung TT, Goycoolea MV. Otitis media with

effusion, Otolaryngology, Vol-II, 3rd edition, W.B. Saunders;

p. 1377–80.

Ullah Z, Ullah M, Ullah S. Surgical management of otitis media

with effusion; A prospective study of 120 patients. J Postgrad Med

Inst 2001;15(2):165–70.

Roberts JE, Rosenfeld RM, Zeisel SA. Otitis Media and Speech

and Language: A Meta-analysis of Prospective Studies. Pediatrics


American Academy of Family Physicians, American Academy of

Otolaryngology-Head and Neck Surgery, and American Academy

of Pediatrics Subcommittee on Otitis Media With Effusion. Otitis

Media with Effusion. Pediatrics 2004;113(5):1412–29.

Karlidag T, Kaygusuz I, Ozden M, Yalsin S, Ozturk L. Resistant

bacteria in the adenoid tissues of children with otitis media with

effusion. Int J Pediatr Otorhinolaryngol 2002;64(1):35–40.

Mills RP, Irani BS, Vaugahan-Jones RJ. Padgham NM. Maxillary

sinusitis in children with otitis media with effusion. J Laryngol

Otol 1994;108:842–4.

Hong CK, Park DC, Kim SW, Cha CI, Cha SH, Yeo SG. Effect of

paranasal sinusitis on the development of otitis media with

effusion: influence of eustachian tube function and adenoid

immunity. Int J Pediatr Otorhinolaryngol 2008;72:1609–18.

Yeo SG, Park DC, Eun YG, Cha CI. The role of allergic rhinitis in

the development of otitis media with effusion: effect on eustachian

tube function. Am J Otolaryngol 2007;28(3):148–52.

Donaldson JD. Acute otitis media. presentation. 2011. Available


Butler CC, MacMillan H. Does early detection of otitis media with

effusion prevents delayed language development? Arc Dis Child


Rashid D, Ahmad B, Malik SM, Rahat ZM, Malik KZ. Otitis

media with effusion—cost effective options. J Coll Physicians

Surg Pak 2002;12(5):274–6.

Yousaf M, Ullah I, Ahmad N, Ali S. The presentation pattern of

otitis media with effusion. J Med Sci 2009;17(1):53–5.

Rovers MM, Black N, Browning GG, Maw R, Zielhuis GA,

Haggard MP. Grommets in otitis media with effusion: an

individual Meta analysis. Arch Dis Child 2005;90:480–5.

Butler CC, Van Der Voort JH. Oral or topical nasal steroids for

hearing loss associated with otitis media with effusion in children.

Cochrane Database Syst Rev 2002;(4):CD001935.

Ahmad SU, Choudhary M, Haque RM. Influence of adenoid

hypertrophy on otitis media with effusion: Bangl J

Otorhinolaryngol 1997;3(1):3–8.

Marcy SM, Shiffman RN. Otitis media with effusin. Clinical

practice guidelines. Pediatrics 2004;113:1412–29.

Hassmann E, Skotnicka B, Baczek M, Piszez M. Laser

myringotomy in otitis media with effusion: long term followup.

Eur Arch Otorhinolaryngol 2004;261:316–20.

Roland PS, Kreisler LS, Reese B, Anon JB, Lanier B, Conroy PJ,

et al. Topical ciprofloxacine/dexamethasone otic suspension is

superior to ofloxacine otic solution in the treatment of children

with acute otitis media with otorrhea through tympanostomy

tubes. Pediarics 2004;113(1 part 1):40–6.

Maw AR. Development of tympanoscerosis in children with otitis

media with effusion and ventilation tubes. J Laryngol Otol


Malik KI, Butta ZI, Mukhtar N, Pal MB. Role of grommets in

otitis media with effusion. Ann King Edward Med Coll





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