MANAGEMENT OUTCOME OF SECRETORY OTITIS MEDIA
AbstractBackground: Secretory otitis media is a common otological manifestation, that most of the timeis left undiagnosed on account of unawareness and negligence in seeking early medical attentionfor trivial ailments. Untreated, it might end up in serious consequences in the form of poor speechand intellectual development and permanent anatomical disabilities within middle ear cleft. Theobjectives of the study were to determine most affected age group, the common etiological factors,to access the efficacy of medical and surgical treatment and finally to find out the complicationassociated with the surgical procedures. Methods: This study was conducted in the ENT, Headand Neck Surgery department of the Ayub Teaching Hospital, Abbottabad from January 2001 toDecember 2003.Only the diagnosed cases of SOM were included in the study. After detailedhistory, clinical examination, routine investigations and special investigations such as pure toneaudiogram and tympanometry were carried out to confirm the diagnosis of SOM . All patientswere initially treated by medical therapy. In cases of failure, underwent myringotomy with orwithout ventilation tube insertion and where indication present adenotonsillectomy and antrallavage was done. Follow up of cases was carried out from 18-24 months. Results: It included 87patients, 58 were males (66.6%) and 29 females (33.3%). Majority of the patients were between5-8 years (62%). The most common aetiological factor was rhinosinusitis (36.7%) followed byhypertrophic adenoids (34.5%). All patients were initially given medical treatment. Out of 87patients,30 patients (34.4%) improved and 57 patients (65.5%) had no response and underwentsurgery. Surgical procedures included myringotomy with and without ventilation tube insertion,adenotonsillectomy and antral lavage. Conclusion:It is concluded from this study thatconservative treatment has a definite role and should be tried before any surgical step is takenhowever surgery is the treatment of choice in more resistant cases.Key Words: Secretory otitis media, otitis media with effusion, myringotomy
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