,HISTORY OF PRESENT ILLNESS: , The patient is a 2-1/2-year-old, with a history of persistent bouts of otitis media, superimposed upon persistent middle ear effusions. 
,HISTORY OF PRESENT ILLNESS : , The patient is a 2 - 1/2 - year - old , with a history of persistent bouts of otitis media , superimposed upon persistent middle ear effusions .