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Abstract l. INTRODUCTION otitis media ~lth effusion is one of tbe co~monest ch~onic otol08 icalcoodit ions of childhood. The condition occurs in ch i l dhood as overt or covert head ng loss presenting as all edl,Jc••nQna,lor behavioral problem. In younger chf Id re n, if; may present as speech snd language delay or 8S an a.rticulation defect. Otten th,e bearing ~o:ss is first detected 00 routine screening examinations before or at 3-5 years of age, Or later at a preschool testing. Sometimes attention is drawn to it by frequent episodes of ohlgia. [Ya,,_ 1987) Al though oU tis lIIedia wi th cffus ion i is associated w:i.th a conductive nearing loss. the degr,ee of this loss varies. and effusion llIay be present in ma.ny patie.nts without significant hearing loss. Tympanometry and determi.nation of the threshold of the aCOUS tic ret Iex were rir s t· introduced :i n !965 as a c 1i n i ca I tool to evalUate the middle ear function. Since then these methods bave been widely used in diagnosis of various types of middle eat patbology, specially otitis media with effusion. A negative midd.le esr pressure of ISO mm”10 or ~ore Or a flat tympanogram should be cons tde r ec pathological and an indication of otitis media”ith eUus ion. IBtue s tone tit a1.. 1985] 2. There is evidence that as high as 261 of patients .111 fail to ijnpr ove ”i th medical treatment. TympaflostQlI)’with insertion of tympanostomy tube is the most cnmmon sursieal procedure performed tor chi 1dr en wi th pl!r-s is tent middle ear effus ion. (B,er-Illite in. t 985]. |