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The ventilation tubes will normally extrude itself once the OME resolves and the underlying cause Is brought under control. Once identified and treatment started, hearing is expected to recover to its prediseased state. It is a common complication of acute otitis media due to prolonged disease process, partial resolution or inadequate antibiotic treatment. Other environmental factors have been shown in numerous epidemiologic studies to be strongly associated with increased prevalence of OME.

All children with Down's syndrome and all children with cleft palate should be assessed regularly for OME. Early phases of OME can be treated with a combination with local and systemic decongestants, antibiotics.
If OME is prolonged, usually beyond 3 months despite multiple nonsurgical intervention,  a ventilation tube (grommet or T-tube) may be inserted.
Depending on tolerability, age of patients, this procedure can be done under local or general anaesthesia.

Enlarged and obstructive adenoids, more so in the presence of recurrent URTI, rhinosinustis, need to be surgically removed. Compare the normal on the left and large adenoids (non-cancerous growth) in the middle 2 pictures.

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