الفهرس 
Introduction and Aim of The WorkOnly 14 pages are availabe for public view
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Abstract
Aim of the work
Is to demonstrate the presence of humeral immunity (immunoglobulin) in the middle Ear effusion and the relationship between immunoglobulin and the middle Ear effusion in a trial to elucidate the mechanism of chronicity of otitis media with effusion.
Also, the bacteriology of middle Ear effusions and its relation to bacteria isolated from the nasopharynx was investigated.
Conclusion
We can conclude that the present of the middle Ear pathogen in the nasopharyngeal cultures strongly suggest that the pathogen present also in the middle Ear space. So, nasopharyngeal cultures may provide useful information about the presence of a pathogen in the middle Ear.
Adenotonsillectomy as primary surgical treatment with grommets application not recommended but when children have recurrence of their middle Ear disease after their initial tube extrude the adenoidectomy is recommended.