In chronic otitis media with effusion, what hearing finding supports proceeding to tympanostomy tube placement?

• A. Sensorineural hearing loss
• B. Documented conductive hearing loss
• C. Normal hearing
• D. Hyperacusis

Answer: (B)

In chronic otitis media with effusion, the problem is fluid in the middle ear that impedes ossicular movement and sound conduction. The key finding that supports proceeding with tympanostomy tube placement is a documented conductive hearing loss, which shows that the effusion is actually affecting hearing. Tympanostomy tubes ventilate the middle ear, drain fluid, and restore better conduction, often improving hearing and reducing recurrence. Sensorineural loss would point to inner ear or neural pathways and isn’t addressed by tubes; normal hearing would imply little or no functional impact from the effusion, and hyperacusis relates to sensory gain in the inner ear rather than middle-ear conduction changes.