<prompt> 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 patientsabcbcdacbd  <response>: 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.According to GhaiIf 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.According to Current otolaryngology 2nded pg 659A 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.Also KnowIndications for early insertion of Tympanostomy tube grommet tube:Cases where spontaneous resolution is unlikely as predicted by season of presenting to OPD i.e. between July to December and a BL hearing impairment of 30 dBIt is causing significant delay in speech and language developmentOME is present in an only hearing ear.Recurrent otitis media. 