The main characteristics of secretory otitis in children

Abstract

The main characteristics of secretory otitis in children and historical concepts on the disease are described, with special reference to the best methods of its early detection. Secretory otitis is marked by serous eff usion into the middle ear behind intact tympanic membrane and without signs of acute infl ammation. The etiology and pathogenesis of the disease have not yet been fully clarifi ed; however, development of the disease is infl uenced by a number of risk factors. Currently, there is no consensus on the disease etiology, and on the choice and timing of appropriate therapy. Secretory otitis frequently occurs as a consequence of acute otitis. Most episodes of secretory otitis subside spontaneously within 3 months; however, recurrent secretory otitis is recorded in 30% to 40% of children. It is generally asymptomatic, while hearing loss is usually the fi rst sign of bilateral disease involvement. Ear endoscopy and pneumootoscopy fi ndings are highly relevant for the diagnosis of secretory otitis. Tympanometry with or without tonal audiometry (depending on the child’s age) is the most important and most common objective examination. In conclusion, secretory otitis is a frequent disease of childhood. As secretory otitis most commonly occurs at the age of 2 to 6 years, ear endoscopy and tympanometry fi ndings are of utmost clinical relevance. If the child is prone to frequent otitis episodes or respiratory infections, thorough examination by an otorhinolaryngologist is warranted to enable timely treatment of secretory otitis.