Indications for the use of ventilating tubes for secretory otitis media.

Seventy-seven children (147 ears) with secretory otitis media (S.O.M.) were surgically treated by myringotomy with aspiration, insertion of ventilating tubes, and adenoidectomy, if indicated. The results of treatment for S.O.M. were analyzed according to the degree of mastoid pneumatization and complications with or without ipsilateral sinusitis. The present study was performed in order to establish indications for the use of ventilating tubes. The results of treatment for S.O.M. in poorly developed mastoids were poor. With an ipsilateral sinusitis the prognosis of S.O.M. was also poor. In some cases of S.O.M., particularly those in well-developed mastoids, either adenoidectomy alone or myringotomy with aspiration alone proved effective for recovery from middle ear effusions. Ventilating tubes are most suitable for the following conditions: (1) in cases of sclerotic or poorly developed mastoids; (2) in cases with ipsilateral sinusitis; and (3) in cases with recurrent effusions after a first myringotomy with aspiration.