Operations in the ear cavity are performed to treat diseases that interfere with hearing and do not subside with conservative treatment methods. One of the most common otorhinolaryngological diseases that manifests itself very often during childhood and affects the ear drum is secretory otitis. It is a condition of the middle ear which is manifested by the accumulation of fluid. More specifically, the serous fluid secreted by the tympanic cavity becomes thick, which makes it impossible to absorb. It happens when the eustachian tube malfunctions or becomes blocked. Surgical treatment of the condition is recommended if symptoms persist after conservative treatment. The procedure of choice is tympanotomy with placement of ventilation tubes, if this is deemed necessary.

Secretory otitis: Causes & Symptoms

Secretory otitis is caused by malfunctions or obstruction of the Eustachian tube, and is manifested by conductive hearing loss. The collection of fluid in the middle ear occurs due to the long-term disruption of the smooth functioning of the Eustachian tube, which leads to insufficient ventilation of the middle ear cavity. The main causes responsible for the dysfunction of the Eustachian tube are the existence of adenoid hypertrophy, the occurrence of successive allergies in the upper respiratory tract or infections in the nose, paranasal sinuses and nasopharynx. The specific diseases that favor the manifestation of secretory otitis are a very common phenomenon during childhood.

Secretory otitis, however, can also occur in adulthood, due to the disturbance of ventilation inside the ear cavity due to dysfunction of the Eustachian tube, caused by allergies, nasal polyps, infections and benign or malignant tumors. The existence of a cancerous neoplasm in the nasopharynx causes its penetration into the pharyngeal opening of the eustachian tube, facilitating the arisal of secretory otitis. The existence of malignancy requires a thorough examination with the appropriate diagnostic means, so that it can be treated promptly and successfully.

Tympanotomy & placement of ventilation tubes: Surgical process

Tympanotomy and placement of ventilation tubes is a minor procedure during which a tiny incision is made in the tympanic membrane using a surgical microscope. The operation aims to open the tympanic membrane and carry out a thorough cleaning of the middle ear from liquid or mucous secretion, in order to treat the secretory otitis and reduce the conductive hearing loss. In the majority of cases, a small ventilation tube is inserted during the procedure to maintain the drainage. The placement of ventilation tubes facilitates ventilation of the middle ear cavity, preventing fluid accumulation and recurrent infections.

Can tympanotomy be performed during childhood?

This surgery is most commonly performed during childhood, but may also be necessary during adulthood. Tympanotomy and placement of ventilation tubes in childhood is performed in conjunction with treatment of the underlying cause of secretory otitis. This is followed, in case it is deemed appropriate, by a procedure of submitting the child to diagnostic tests such as X-rays, magnetic resonance imaging or endoscopy of the nasopharynx in order to find the cause that provoked the condition, such as the existence of adenoid hypertrophy. If adenoid hypertrophy is confirmed, then tympanotomy and placement of ventilation tubes is combined with the simultaneous adenoid removal. The treatment of secretory otitis in the first stage is conservative, however if after 6 months the condition persists, then surgical treatment is recommended. In childhood, tympanotomy and placement of ventilation tubes is performed under general anesthesia, while in adults, local anesthesia is usually performed.