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Aetiology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The aetiology of secretory otitis media is not fully understood.

The following factors have been implicated which is thought to increase the risk of developing OME:

  • age - 6 years or younger
  • household smoking
  • attending a day care centre
  • large number of siblings
  • low socioeconomic group
  • recurrent upper respiratory tract infections
  • bottle feeding (1).

The importance of Eustachian tube dysfunction is, however, widely accepted. One possible mechanism is that negative pressure develops within the middle ear cavity as a result of Eustachian tube dysfunction and the continual absorption of oxygen by respiratory epithelium. This negative pressure then encourages the formation of a mucosal transudate. Some common causes of tubal dysfunction are

  • functional problems and its intrinsic system of opening and closing
  • immunological and genetic disorders
  • gastroesophageal reflux
  • rhinosinusitis
  • enlarged adenoid (2)

Thus, secretory otitis media may be caused by:

  • nasopharyngeal obstruction:
    • large adenoids
    • nasopharyngeal tumours in adults
  • otic barotrauma
  • sinusitis
  • there is an increased incidence in
    • cleft palate - due to impaired function of the Eustachian tube associated with palatal anomaly (2)
    • Down's syndrome - caused by impaired immune system and mucosal abnormality which results in an increased susceptibility to ear infection (2)
  • allergic rhinitis may also predispose to secretory otitis media by affecting Eustachian tube function.
  • passive smoking may be a factor

However, many cases of secretory otitis media have no apparent cause.

Reference:


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