II. Definition
- Retention of transudate fluid in middle ear
III. Signs:
- Dull grey, amber or red TM
- Bubbles or air fluid levels
- TM retracted and moves to negative pressure (Eustachian Tube Dysfunction)
- TM thickened and increased vascularity to opaque
- Hearing Loss (<30 DB)
- Images
IV. Course: Natural course following Otitis Media
- At 2 weeks: 70% have persistent effusion
- At 4 weeks: 40%
- At 2 months: 20%
- At 3 months: 10%
V. Management
- Otolaryngology referral indications
- Persistent serous effusion >3 months
- Adhesive Otitis Media signs
-
Myringotomy and Tympanostomy Tube placement Indications
- See Tympanostomy Tube for indications
- Consider after 3 months of persistent effusion
- Measures shown to be not efficacious
- Avoid Decongestants
- Avoid Antihistamines
- Avoid antibiotics
- Avoid Systemic Corticosteroids
- Consider Intranasal Corticosteroids if comorbid Allergic Rhinitis
- (2012) Presc Lett 19(2): 9