Secretory otitis media in the adult

Middle ear effusion secondary to Eustachian tube obstruction may complicate nasal and nasopharyngeal conditions. It may be the presenting feature of a nasopharyngeal tumour. A series of 94 adult cases of middle ear effusion was reviewed. Examination under anaesthetic of the postnasal space was performed in each case, but did not result in the diagnosis of a tumour in any patient in whom it was not strongly suspected clinically on the basis of non-otologic features. Patients having grommet insertion had better hearing for 9 months postoperatively than those having myringotomy alone. Treatment of coexisting nasal, nasopharyngeal or sinus conditions at the time of grommet insertion did not result in any long-term improvement in hearing levels in comparison with those patients in whom no such aetiological factor was identified.