Elevated bone conduction thresholds associated with middle ear fluid in adults

Longitudinal observations of adult patients with documented cases of otitis media revealed fluctuations in bone conduction thresholds as well as air conduction thresholds. Previous investigations in this area presented conflicting information regarding temporary and permanent effects of serous otitis media on sensori-neural function. We conducted a detailed study, including complete otologic, audiologic, and tympanometric evaluation, of 30 adult patients exhibiting serous otitis media. Myringotomies were performed on all patients after appropriate medical management failed to clear the middle ear fluid and subsequent hearing loss. Pre- and postmyringotomy audiograms support our conclusion that middle ear fluid can produce artifactual shifts in bone conduction thresholds. Although the data presented was collected from a cohort of adults, the clinical implications are applicable to the pediatric population. We have observed a similar shift in bone conduction thresholds in children exhibiting serous otitis media, and we have observed improvement in the thresholds with removal of the fluid either by appropriate medical management or by myringotomy with fluid aspiration.