RESUMO
Secretory otitis media [SOM] is the usual type of middle ear effusion in adults, characterized by presence of thin [serous] non purulent fluid in the middle ear space. To evaluate the response to conservative medical treatment of serous otitis media versus surgical treatment [myringotomy]. A prospective study enrolling 54 patients with SOM, aged 21-60 years was conducted during the period from the September 2006 to the October 2007 at Al-Kadhimiyia teaching hospital in Baghdad. Medical treatment used for 10-14 days. The response to treatment was evaluated 2 weeks following medical treatment using symptomatic improvement, tympanogram and pure tone audiogram. 39 patients did not respond to medical treatment were treated by myringotomy and aspiration of middle ear fluid [under local anesthesia] was done and the response was evaluated, after 1 and 2 months by using the same above mentioned assessment methods. 72% of the patients didn't improve following medical treatment, 77% of them have bilateral serous otitis media. Myringotomy was done for these non-responders; of whom 95% were improved. Myringotomy was effective, safe and easy method for treating adults with SOM did not improve following conservative medical treatment and, or for those who asked for an immediate relief of their symptoms, with a low recurrence rate