Serous otitis media: symptoms, causes and treatment

An acute otitis that is not treated properly becomes serous. The condition involves consequences such as temporary hearing loss.

Last update: 13 January, 2022

Serous otitis media (WHO) is the consequence of an acute inflammation of the middle ear with poor resolution. The disorder is also caused by allergies that block the Eustachian tube, causing temporary hearing loss and congestion in the ears. During the disorder, the patient secretes water-like fluids from the ear canal, but without infection.

This alteration occurs in people of any age. However, its incidence is higher in children. The Commission for the Early Detection of Deafness asserts that the impact is higher in infants with comorbidities of various kinds.

What are the causes of serous otitis media?

Seromucous or effusion otitis, as the disease is also known, derives from the incorrect resolution of acute otitis media. The latter, as the Clínica Universidad de Navarra explains, it is infectious-contagious and sporadic or repeated. During the process of inflammation and bacterial disinfection, fluid remains in the middle ear, which leads to SOM.

Some environmental factors also increase the risk. For example, feeding babies lying flat increases reflux from the bottle into the Eustachian tube. Also, because the ear canals are smaller, secretory otitis tends to occur more in children.

Other causes are those linked to the following factors:

  • Palatal clefts.
  • Cold congestion.
  • Surgeries that compromise the auditory tube.
  • Sudden changes in air pressure.
  • Chronic sinusitis.
  • Radiation treatments for head and neck cancer.
Children are the population group that most suffers from serous otitis media.

Symptoms of serous otitis media

With a tendency to change over the course of the disease, the fluid behind the eardrum can be purulent, mucous, serous, or combined. Although sometimes it is asymptomatic, common sign is hearing loss, evident in children when they do not respond when spoken to or turn up the volume of the television a lot.

As for adults, patients perceive plugging, increased pressure in the ear, and impaired hearing acuity, especially after allergies, upper respiratory tract infections, air travel or diving.

The signs vary according to the person:

  • Ringing or tinnitus.
  • Increasing earache.
  • Vertigo or loss of balance.
  • Problems in school performance.

WHO Diagnosis

Physical examination of the ears is essential to detect seromucous otitis. Otolaryngologists perform an otoscopy, in which they look for air-fluid levels. Similarly, the nasopharynx is explored as a method of ruling out adenoid hypertrophy.

They are not complicated analyses. The doctor gently inserts the tip of the otoscope to visualize the eardrum and check for movement, retraction, and color of the membrane.

Another test is tympanometry, performed with a speculum in the external auditory canal. This test measures the pressure in the ear and emits a tone so that the tympanic box returns it to the tympanometer. When there is fluid accumulated in the middle ear, the sound is abnormal.

Treatment for serous otitis media

When the disorder is recurrent, surgical intervention greatly improves the condition. These are myringotomy (which sometimes requires the insertion of drainage tubes) and adenoidectomy. Another procedure is autoinflation.

But not all cases of serous otitis require treatment. Most patients progress satisfactorily with corticosteroid, mucolytic, and antihistamine-type drugs.

Depending on the duration of symptoms, you may need a round of antibiotics, if considered by your doctor. If the discharge lasts for about 6 weeks, hearing tests or additional examinations are necessary. The path to take is decided by the specialist.

Antibiotics are reserved for cases where an active bacterial ear infection is confirmed.

Confusion with other otitis

There are different types of otitis and this often confuses those who suffer from it. Not all variations are related to the same causes or are solved with the same treatment.

For example, swimmer’s ear is common when you don’t dry your ears well. More cases are reported in summer, because it is the time of greatest attendance at swimming pools and beaches. It has absolutely nothing to do with the serous or exudative form. Acute otitis media is usual in autumn and winter, product of colds and colds.

Certain recommendations help prevent serous conditions in the ears. It is advisable not to feed babies in a supine position and to breastfeed as much as possible.

It is also convenient to stay away from cigarette smoke, clean children’s toys frequently, wash your hands and be up to date on vaccinations, mainly the pneumococcal, since it fights common ear infections.

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