Following statements are true about otitis media with effusion in a child -a) Immediate myringotomy is doneb) Type B tympanogramc) The effusion of middle ear is steriled) Most common cause of deafness in a child in day care patients

There is no doubt about options b, c and d that they are correct. Option ‘a’ says – immediate myringotomy should be done. This is incorrect as myringotomy is done only if patient does not respond to medical treatment in 3 months. According to Ghai If effusion persists beyond 3 months, tympanostomy tube insertion may be considered for significant hearing loss (>25 dB). Other indications of tube placement are ear discomfort or pain, altered behavior, speech delay, recurrent acute otitis media or impending cholesteatoma formation from tympanic membrane retraction”. According to Current otolaryngology 2nd/ed pg 659 “A large number of patients with OME (otitis media with effusion) require no treatment, particularly if the hearing impairment is mild. Spontaneous resolution occurs in a significant proportion of patients. A period of watchful waiting for 3 months from the onset (if known) or from the diagnosis if onset unknown), before considering intervention is advisable”. Also Know Indications for early insertion of Tympanostomy tube/ grommet tube: Cases where spontaneous resolution is unlikely as predicted by season of presenting to OPD (i.e. between July to December) and a B/L hearing impairment of >30 dB It is causing significant delay in speech and language development OME is present in an only hearing ear. Recurrent otitis media.