###Human: How can adhesive otitis with SOM be treated? ###Assistant: Hi, Welcome to iclinq.com. Can you upload audiometry report? What are the complaints now? Is there discharge or hearing deficit? Any pain or giddiness? Nose CT seems fine (attachment removed to protect patient identity). Ear shows mastoiditis. Have they done an ear under microscope examination? If it is a clearly diagnosed adhesive otitis media supported by audiometry it will need surgery. But which ear to be done first will depend on audiometry. Is there any nasal complaints?