The fluid level and air bubble level in otoscopy indicates:

(Middle ear effusion): Ref: 84-D (63-D 4th)Qtoscoopic Findings In Middle Ear Effusions* Typmpanic membrane is oftendull and opaque with loss of light reflex it may appear yellow, gray or bluish in colour.* Thin leash of blood vessels may be seen along the handle of malleous or at the periphery of tympanic membrane and differs from marked congesion of ASOM.* Tympanic membrane may show varying degree of retraction. Sometimes it may appear full or slightly bulging in its posterior part due to effusion* Fluid level and air bubbles may be seen when fluid is thin and tympanic membrane transparent* Mobility of the tympanic membrane is restricted* Complication of chronic serous ottitis media:1. Atrophic tympanic membrane and ateletctasis of the middle ear2. Ossicular necrosis3. Tympanosclerosis4. Retraction pockets and cholesteatoma5. Cholesterol granuma* Surgical treatment of chronic secretory otitis media1. Myringotomy and aspiration of fluid2. Grommet insertion3. Tympanotomy or cortical mastoidectomy4. Surgical treatment of causative factor (Adenectomy tonsillectomy/or wash out of maxillary antra, done at the of time of myringotomy)