Clinical Analysis of Secretory Otitis Media Misdiagnosed as Other Ear Dis-eases

CHEN Nijun; SUN Xingmei; WANG Jichan

doi:10.3969/j.issn.1002-3429.2025.07.001

Abstract：Objective To analyze the causes of misdiagnosis of secretory otitis media(SOM),and to explore how to reduce the misdiagnosis rate and improve the accuracy of clinical diagnosis by optimizing the diagnostic process.Methods From February 2021 to February 2023,12 patients with SOM who were misdiagnosed as other otological diseases at initial di-agnosis were selected.Their clinical data were retrospectively analyzed,focusing on the symptoms and manifestations,misdi-agnosis at initial diagnosis,examination methods and diagnosis process,and the differential diagnosis was made according to their clinical manifestations and other otological diseases.Results Among the 12 patients,4 patients were misdiagnosed as low-frequency sudden hearing loss due to symptoms such as ear blocking sensation,tinnitus,and hearing loss,3 patients were misdiagnosed as sensorineural hearing loss due to symptoms such as otalgia and ear blocking sensation,and 5 patients were misdiagnosed as acute otitis media due to ear fullness sensation and low-frequency tinnitus.Otoscopy showed that 4 patients had sunken or cloudy eardrums.The symptoms of the 12 patients were not significantly improved after initial treatment.After referral,the patient was diagnosed with SOM by otoscope review,acoustic immittance test(all B type)and tympanic mem-brane puncture.The duration of diagnosis was1～6(3.26±1.05)weeks.All the 12 patients received symptomatic treat-ment,including tympanic membrane puncture,nasal decongestant,antibiotics and improving the ventilation function of the middle ear cavity.The symptoms were significantly improved and the hearing was restored.There was no recurrence during 6 months of follow-up.Conclusion SOM has various symptoms and is easily confused with other otological diseases.Strengthening the understanding of the disease and improving the diagnostic methods,especially in combination with acoustic immittance test and tympanocentesis,will help to improve the diagnostic accuracy of the disease and reduce the occurrence of misdiagnosis.