This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: ENT
[{'content': 'Following statements are true about otitis media with effusion in a child -a) Immediate myringotomy is doneb) Type B tympanogramc) The effusion of middle ear is steriled) Most common cause of deafness in a child in day care patients \nSelect and explain. \nA. abc, B. bcd, C. ac, D. bd', 'role': 'user'}, {'content': 'Answer: B \nExplanation: There is no doubt about options b, c and d that they are correct. Option ‘a’ says – immediate myringotomy should be done. This is incorrect as myringotomy is done only if patient does not respond to medical treatment in 3 months.\nAccording to Ghai\n\nIf effusion persists beyond 3 months, tympanostomy tube insertion may be considered for significant hearing loss (>25 dB). Other indications of tube placement are ear discomfort or pain, altered behavior, speech delay, recurrent acute otitis media or impending cholesteatoma formation from tympanic membrane retraction”.\n\nAccording to Current otolaryngology 2nd/ed pg 659\n“A large number of patients with OME (otitis media with effusion) require no treatment, particularly if the hearing impairment is mild. Spontaneous resolution occurs in a significant proportion of patients. A period of watchful waiting for 3 months from the onset (if known) or from the diagnosis if onset unknown), before considering intervention is advisable”.\nAlso Know\nIndications for early insertion of Tympanostomy tube/ grommet tube:\n\nCases where spontaneous resolution is unlikely as predicted by season of presenting to OPD (i.e. between July to December) and a B/L hearing impairment of >30 dB\nIt is causing significant delay in speech and language development\nOME is present in an only hearing ear.\nRecurrent otitis media.', 'role': 'assistant'}]