A surgical procedure, which includes myringotomy, aspiration of fluid and the insertion of ventilation tubes (grommets) in the anterior tympanic membrane (Fig. 1) , is the most effective option in treatment of OME. The main problem with ventilation tubes is secondary infection and post-operative otorrhea, which can be managed using antibiotic eardrops. 34, 35 However, increasing antibiotic resistance of bacterial pathogens 36 and possible ototoxicity of topical antibiotics 37 can complicate the antimicrobial therapy in post-surgical management of otitis media. Other non-surgical approaches in treatment and prophylaxis of OME include traditional methods, such as combined steroid Á/antimicrobial therapy 38, 39 and polyvalent pneumococcal vaccination, 40, 41 and relatively new methods based on herbal medicine 42, 43 and homeopathy. 44, 45 The chronic condition of otitis media is associated with proliferative changes in the middle ear tissues, especially in the surface middle ear mucosa, which is presented in OME as a modified pseudostratified epithelium, 46 where basal cells are differentiating into goblet cells, 47 goblet cells are proliferating with enhanced secretory activity 48 and formation of mucus glands occurs 49, 50 (Fig. 1) .