Abstract
Objective: To determine the frequency of secretary otitis media (OME) in the region of twin city and to determine variations related to gender, environment and socioeconomic status.

Design: Comparative cross sectional study.

Place and Duration of study: One year from July 2010 to July 2011at Social Security Hospital Islamabad and at Holy Family Hospital Rawalpindi.
Patients and Method: Total 600 children (3-5 years) from schools of Rawalpindi and Islamabad were evaluated. Sampling was done by consecutive sampling technique. Schools were divided into three socioeconomic groups high, middle and lower,200 children in each group. To over- come seasonal variation 50 children were examined every month. Data collection tool were questionnaire, otoscopes, tympanometer, and audiometer. Written permission was taken two days before visit. Complete otorhinolaryngological examination was carried out. OME was diagnosed clinically with dull, retracted or bulging immobile tympanic membrane and confirmed by type B curveon tympanometry.Frequencyof OME was calculated. Biostatic evaluation of results was done by using spss version10 and chi-square test, p value<0.05 was considered significant.
Results: Total 600 children were included. Mean age was 4 years. 73 children were bottle fed. Two children had cleft lip and palate repair. 49 were mouth breather, rhinitis was in 203 children,18were with delayed language and hearing loss and AURTI in 63 children. 11 cases excluded from study due to perforation in tympanic membrane. Clinically OME was found in 78 children. Tympanometry was done in these 78(13%) childrenwith dull, immobile and retracted tympanic membrane.OME with type B curve was in 69(11.5%) and with hearing loss of 35-40 dB, mean was 37.5dB.9(1.5%) children showed type C curve.
Common symptoms in children with abnormal tympanogram were rhinitis in 39(50%), mouth breathing in 28(35.8%), cleft lip and palate in 2(2.5%), hearing loss and delayed language development in 17(21.7%) and AURTI in 14(17.9%) children. Most of the children showed combinations of symptoms. All diagnosed cases were performing poorly in their day to day school activities. Frequency was found 11.5% in population of 3-5 years in twin city.
Conclusion: In conclusion OME is a common disease may result in serious morbidity in the form of delayed language development and poor performance at school due to hearing loss in 3-5 years age group.

Key words: Otitis media, secretory, hearing loss