From the Guidelines
Treatment for left serous otitis media typically begins with watchful waiting for 3 months as many cases resolve spontaneously. This approach is recommended by the American Academy of Otolaryngology-Head and Neck Surgery, as stated in the clinical practice guideline: otitis media with effusion executive summary (update) 1. If symptoms persist, medical management may include oral antihistamines or nasal steroids to reduce inflammation and fluid buildup. However, according to the clinical practice guideline: otitis media with effusion 1, antihistamines and decongestants are ineffective for OME and are not recommended for treatment.
For cases unresponsive to medical therapy, surgical intervention with myringotomy and tympanostomy tube placement may be necessary to ventilate the middle ear and drain fluid, as recommended by the clinical practice guideline: otitis media with effusion 1. This procedure is typically performed under local or general anesthesia and the tubes usually remain in place for 6-12 months before falling out naturally. Addressing underlying causes like allergies, sinusitis, or adenoid hypertrophy is crucial for preventing recurrence.
Some key points to consider in the management of left serous otitis media include:
- Watchful waiting for 3 months is recommended for children who are not at risk for speech, language, or learning problems 1
- Surgical intervention may be necessary for children with persistent OME and hearing loss or other signs and symptoms 1
- Adenoidectomy may be recommended for children with recurrent OME or those who are at risk for speech, language, or learning problems 1
- Antihistamines and decongestants are not recommended for treatment of OME due to lack of efficacy and potential harm 1
Overall, the goal of treatment for left serous otitis media is to alleviate symptoms, prevent complications, and improve quality of life, while minimizing the risk of harm from unnecessary interventions.
From the Research
Treatment Options for Left Serous Otitis Media
- The treatment for left serous otitis media typically involves watchful waiting, as the condition often resolves spontaneously 2, 3, 4.
- According to the Clinical Practice Guideline: Otitis Media with Effusion (Update), clinicians should manage the child with OME who is not at risk with watchful waiting for 3 months from the date of effusion onset (if known) or 3 months from the date of diagnosis (if onset is unknown) 2.
- The use of antimicrobial therapy, antihistamines, and decongestants is not recommended for treating OME, as they have no significant effect on the course of the condition 2, 3, 5.
- Tympanostomy tubes may be recommended for children with bilateral OME and documented hearing loss, or for those who have not responded to watchful waiting 2, 3, 6.
- Adenoidectomy may be considered in children with adenoid hypertrophy, especially if they are under the age of 4 2, 6.
Surgical Intervention
- Tympanostomy tube insertion is a common surgical intervention for OME, which can help to restore hearing and prevent the development of cholesteatoma in the middle ear 3, 6.
- Adenoidectomy can enhance the effectiveness of tympanostomy tubes and is indicated in children with adenoid hypertrophy 2, 6.