Secretory otitis is a condition that occurs after an acute inflammation of the middle ear. Antibiotics are often prescribed unjustifiably because of it
A typical story related to secretory otitis is something like this. The child has just started kindergarten and already in the 9th month he gets an otitis media, which is cured with antibiotic therapy. However, after treatment, secretion remains in the middle ear, which we call secretory otitis. Once or twice a month, the condition becomes acute, and each time it is declared that the child has an ear infection again. But, in fact, it is about the same ear infection that was not cured, but only healed.
And the worst thing about all this is that an antibiotic is given immediately. In a large percentage of cases, antibiotic therapy is not necessary, unless there are pronounced symptoms such as a high body temperature and a general bad condition of the child. Even when the ear leaks, in many cases systemic antibiotic therapy is not necessary, but only local therapy of the “leaking” ear in the form of ear washing and antibiotic drops. A child’s frequent illness that prevents him or her from going to kindergarten, frequent antibiotic therapy, the child’s poor hearing and the fear that the child will become deaf… All of this greatly disturbs parents. But let’s start from the beginning.
Secretory otitis is a condition, not a disease
Residual secretory otitis is a condition that occurs after an acute otitis media is over. It is considered that it is normal for up to three months that there is still a secretion in the middle ear after the inflammation, which is removed spontaneously (by itself) through the Eustachian tube during that period.
If this does not happen, this so-called residual secretory otitis becomes a new diagnosis, i.e. secretory otitis. In the case of secretory otitis, a thick, sticky secretion is present, hence the name “glue ear”.
The child will not become deaf
This secretion causes impaired hearing, due to which it is possible that there is also a pronunciation disorder. Quite often, a child with secretory otitis changes some sounds with others, since the child mishears, so he says, for example, lodta instead of ball or buglica instead of balls and the like. There are also occasional pains that result from the pressure of secretions in the ear on the eardrum.
A child with poor hearing may be nervous due to communication problems or have problems following lessons (if it is a schoolboy), although secretory otitis is mostly a condition of preschool children. Parents have a mostly unjustified fear that their child will forever be hard of hearing or will become deaf.
Frequent “acute ear infections” that are not
The unpleasant side of this condition is that the secretion in the middle ear is the basis for the “acute” inflammation of the middle ear (the inflammation “flares up” again). This can happen during any respiratory infection of the upper respiratory tract in which the nose is blocked due to secretions and swelling of the mucous membrane.
Considering that respiratory infections are common in kindergarten children, not to mention constant, the probability of acute secretory otitis is high. That’s how it happens with some children. They have an “acute ear infection” every month or more often, which is not actually the true meaning of that diagnosis, as explained before.
The tendency to develop secretory otitis may be associated with hypertrophy of the third tonsil.
Establishing a diagnosis
Secretion in the middle ear is diagnosed with an otorhinolaryngological examination and tympanometry, a painless test that measures the pressure in the middle ear and proves the presence of secretions.
Possible complications
It rarely happens that secretory otitis becomes chronic otitis requiring a serious therapeutic approach with “major” ear surgery. It is also extremely rare for secretory otitis to cause permanent hearing loss.
Both complications of secretory otitis are mostly possible after a long-term condition lasting more than a year in children who are not under medical control.
Treatment in the acute phase
- Treatment in the acute phase (if general symptoms such as a high temperature or general bad condition of the child are not pronounced) is carried out with symptomatic therapy, that is, without antibiotics.
- Decongestant drops or nasal sprays are given and the nose is rinsed with saline solution
- Ibuprofen and/or paracetamol are given for pain and to lower the temperature
- If the ear has leaked, it is necessary to flush the toilet with saline solution or boric water and then drip some antibiotic drops into the ear for a few days until the ear leaks stop.
If the condition does not improve within 72 hours or if it worsens, it is necessary to contact a doctor who will consider the need for antibiotic therapy or even urgent surgical treatment, i.e. the placement of ventilation tubes.
Antibiotic drops are not dripped into the ear if the ear has not leaked. In this case, with the aim of prevention and treatment, it is better to use analgesic drops, i.e. plant-based sprays or some anesthetic substances.
Treatment in the resting phase
In the quiet phase of secretory otitis, secretolytics are given in the form of syrup or granules. This is given for three weeks, then a break of one month is made, and the course is repeated. The task of mucolytics is to dilute the secretion in the middle ear and allow it to drain through the Eustachian tube into the nasopharynx.
At the same time, it is good to blow auto-inflating balloons. These are balloons that are blown into the nose, opening the Eustachian tube, which also allows secretions to flow out of the middle ear. In order to administer these balloons, the child needs to know how to blow his nose well. But they should not be used when the child has an infection, so there is secretion in the nose.
It is good to spray a hypertonic solution in the nose with xylitol, an extract from strawberries, for which there is evidence that it works in secretory otitis.
If there is no improvement after six months, the installation of ventilation tubes is indicated, for which it is necessary to contact an otorhinolaryngologist. Very often, the removal of the third tonsil, the so-called tonsil, is done at the same time as the installation of ventilation tubes in the eardrums. adenoidectomy.
Possibility of spontaneous healing
This observation period of six months can be extended, especially if the six-month period expires at the beginning of spring or summer. Namely, in the case of secretory otitis, climatic conditions play a major role in healing. Secretory otitis is a problem of the cold months in the season of respiratory infections, and during the warmer part of the year, if and when the child has the opportunity to swim (especially at sea), spontaneous healing of secretory otitis can occur, which is not rare. For this reason, the observation is extended until autumn.
Find more professional advice at the polyclinic for the diagnosis and treatment of ear, nose and throat diseases and for minimally invasive aesthetic surgery of the head and neck in Alba Rubra.
This text was created in collaboration with portal “ADIVA – your portal for health”
