Correlation of magnetic resonance findings with audiological findings in secretory otitis media

Secretory otitis media (SOM) is a disease characterized by the presence of fluid in the middle ear cavity without signs of local or systemic infection such as pain or fever. Chronic secretory otitis media (CSOM) relates to the permanent presence of secretion in the middle ear for more than 3 months. SOM is diagnosed by anamnesis, physical examination and audio-tympanometry tests (ATT). There are some reasons which cause to diagnose insufficiently or a failure in diagnosing such as sclerotic plaques due to middle ear infections, narrowing of the external ear canal and difficult examination of syndromic children. In this study, we aimed to demonstrate the efficacy of MRI in the diagnosis and follow-up of OME by using short-term (approximately 3 minutes) temporal bone MR with T2 sequence. 73 patients in the CSOM diagnosis group were the patients who firstly applied to our clinic. Temporal MRI, otoscopic examination, and audiological tests were performed two days before myringotomy in all 73 patients diagnosed with CSOM. 54 patients in the CSOM follow-up group had previously undergone bilateral ventilation tube (VT) due to CSOM. Short-term T2 sequence temporal MRI, otoscopic examination and audiological examinations were applied to all patients. 134 ears of 73 patients were compatible with CSOM when otoscopy and audiological examinations were performed. In all 134 ears, T2-sequenced short-term MRI showed the presence of fluid in the mastoid cells, while only 120 of them had fluid in the middle ear. Fluid was seen in 120 of the 134 ears that underwent myringotomy, while no fluid was seen in 14 ears. Six of 54 patients in the CSOM follow-up group were excluded from the study because they were compatible with OME recurrence. 96 ears of 48 patients were evaluated. Short-term T2 sequence MRI of 96 ears with normal otoscopy and audiological examinations showed that 35 ears had fluid in the mastoid cells. Along with the eustachian tube, the function of mastoid cells is also very important in middle ear ventilation. Among the current methods, the most effective method for evaluating the fluid in mastoid cells is short-term T2 sequence temporal MRI, and it may be used as an auxiliary examination in cases suspected of SOM management.