Current conservative treatment of childhood chronic secretory otitis media (a survey and discussion)

A questionnaire on medical treatment of childhood secretory otitis was posted to all Consultant Otologists in the Thames Regions of the National Health Service. Questions dealt with indications for medical management, choice of treatment, and indications for omitting medical therapy in favour of immediate surgery, or giving no treatment at all. 86 questionnaires were completed. 81.4 per cent of respondents used medical treatment, but there was no consensus as to the drug or combination preferred. Oral decongestant preparations were the most popular. 87.1 per cent of users of medical therapy sometimes omitted it in favour of immediate surgery, most commonly because previous treatment by another practitioner appeared a failure. 63.1 per cent of all respondents left some cases completely untreated. The views of experienced otologists on the treatment of 'glue ear' vary widely, and there is no acceptable evidence to support any method of medical therapy. Large-scale trials are needed to clarify the position.