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Recovering from surgery for Secretory otitis media - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Ear, Nose and Throat Problems
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1722 Questions
User :   Hello Doctor,My mother has a ear related trouble. She hears alright with left ear, but with right ear she hears a higher pitch at a lower volume. This is quite annoying to her, and has been a symptom for last 1 month.
Doctor :   Hi
User :   Hello Doctor
Doctor :   ok
User :   Great to hear from you
User :   Are you an ENT specialist?
Doctor :   so now, she has this issue since 1 month, is that right ?
Doctor :   i have experience in al most all fields
Doctor :   may i know whats your moms age ?
User :   her age is 60.
Doctor :   has she had any ear infections before
User :   no
Doctor :   does she have any ringing sensation in her ears ?
User :   ok, once 3-4 years back she had a fungal infection in ears.
Doctor :   ok
User :   no.
Doctor :   is she diabetic ?
User :   no.
Doctor :   does she work , or what was her occupation earlier ?
User :   she is a housewife.
Doctor :   ok
User :   we have already shown her to a doctor
User :   but the treatment has not improved her condition
Doctor :   Now to know, what exactly is in her ear, you need an audiogram to know, which frequcies are affected
Doctor :   what has she been treated with?
User :   audiogram has been done.
Doctor :   what was the report ?
User :   she was diagnosed with "secretory otitis media"
Doctor :   ok,
Doctor :   so there is fluid in her middle ear
Doctor :   ok
User :   yes
User :   and she underwent a surgery
Doctor :   so was she advised any antibiotics, or any procedure to put a tube in her middle ear ?
User :   on 25th sept. It is called "Myringitomy"
Doctor :   ok, so myringotomy is already done . ok
Doctor :   so is she better ?
User :   she was first given "xyzal" initially for 10-15 days
Doctor :   ok
User :   which didnt improve... so surgery.
Doctor :   ok
User :   and now surgery also has not improved it much !!
User :   it has only been 5 days today.
Doctor :   u told me that surgery was done on 25th sept right ?
Doctor :   i understand, that
Doctor :   but post surgery due to the inflammation in the operated area, the true benefit is not observed very soon
User :   we took a second opinion yesterday from another doctor. he said fluid is still there!
Doctor :   for the exact results to be seen give at least 10 days post procedure , so that the effects can be seen
Doctor :   post surgery, the fluid oozes from the surgical wound as well
Doctor :   so be patient for some time,
User :   the surgeon has initially said it will be perfect in a day.
Doctor :   also, was any small tube placed in the ear membrane to drain the fluid?>
User :   no, no such tube was placed
Doctor :   ok
User :   there was a tube inserted in the throat though
User :   during the operation.
Doctor :   usually in secretory otitis media, a small tube is placed during the procedure, so that the excess fluid is drained to the exterior
User :   is the tube supposed to be there post operation?
Doctor :   yes
User :   no, there is no tube in her ear. nor was it immediately after the operation.
Doctor :   so when u took a second opinion, what was his inferance ?
User :   he said fluid is still there, and gave some medicines and asked to come back in a week.
Doctor :   ok
User :   1. Allegra 2. Nasivion
Doctor :   ok
User :   what is your suggestion doctor?
Doctor :   actually a grommet (a small tube) is placed inside the ear membrane for air to circulate and remove the fluid as well
Doctor :   this had to be done along with myringotomy
Doctor :   i would advise, you to ask your surgeon, why was the tube not placed and the possibility to do it now
User :   ok. but his advice was "take medicines for a month, and if it doesnt improve then we will have to do another surgery"
User :   and my mother panicked at the thought of another surgery
Doctor :   when was this ?
User :   yesterday
Doctor :   ok, i think he intends to do the insertion of grommet now
Doctor :   and he wants the fluid to clear with medicines
User :   so, you think this was a mistake from his side?
Doctor :   each doctor works on his principles and experience
User :   ok
Doctor :   he may have felt that just a myringotomy would help and insertion of grommet not be needed
User :   but would 30 days be too late to insert grommet according to you?
Doctor :   but the best results are achieved by inserting a grommet which relieves the fluid build up, and allows air to circulate as well
Doctor :   no, not as such
Doctor :   since the fluid is still there, insertion of grommet will definitely help and clear the fluid build up
User :   ok, but my mother is not ready for another surgery :(
Doctor :   i understand her apprehension
User :   is it possible by any means without surgery?
Doctor :   ?
but did she have any complications ? with surgery
Doctor :   without surgery, the fluid may remain for some more time
User :   well the surgery didnt improve her problem
User :   so she has lost faith in the doctor
User :   and also she is in general very scared of operations.
Doctor :   and if that fluid gets infected it can cause suppurative otitis media ( infection and pus formation )
Doctor :   ok
User :   oh...
Doctor :   you can ask the doc, why he did not consider placement of the grommet tube ( tympanostomy tube)
User :   so what is the ideal time frame to get the surgery done by?
Doctor :   any time, is good
User :   ok
Doctor :   i hope i have solved your doubts
User :   ok thank you doctor
Doctor :   you are welcome
Doctor :   thanks for consulting me and i hope everything will work out soon and your mother will feel better

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