Serous otitis media

The diagnosis of serous otitis media (or otitis media with effusion) is based on the presence of sterile fluid in the middle ear cavity, without signs or symptoms of acute inflammation. On otoscopy, the most characteristic findings include a retracted or neutrally positioned tympanic membrane, an opaque or yellowish appearance, and air-fluid levels or air bubbles may be observed behind the eardrum, indicating the presence of fluid. Tympanic membrane mobility is reduced on pneumatic otoscopy due to fluid in the tympanic cavity, but without bulging or signs of intense hyperemia as in acute otitis media. The tympanic light reflex may be distorted or absent. Clinically, serous otitis media presents with symptoms such as conductive hearing loss, a sensation of fullness in the ear, or aural fullness, but without severe pain or fever.