The presence of fluid in the middle ear is not a positive indication for surgery. Most cases will respond to medical management and controlled middle ear inflation. However, myringotomies are usually the treatment of choice in young children with serous otitis and should be performed in conjunction with the thorough removal of all accessible adenoid tissue. In a series of 258 ears containing fluid, 96.9% were successfully treated by a complete adenoidectomy, myringotomy, and postoperative middle ear inflation when indicated. Intratympanic tubes were not used.
Gottschalk GH. Serous Otitis: A Conservative Approach to Treatment. Arch Otolaryngol. 1972;96(2):110–112. doi:https://doi.org/10.1001/archotol.1972.00770090184003
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