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What Is Otitis Media With Effusion?

Medically Reviewed by Jabeen Begum, MD on November 17, 2021

Otitis media with effusion (OME) refers to fluid buildup in your middle ear. It usually happens when the fluid can't drain out of your ear, typically after an infection.This type of ear infection is common in children ages six months to three years. OME affects males more than females.

The fluid generally clears up on its own within four to six weeks. It may persist, though, and the child may need to undergo surgery.

What Is Otitis Media With Effusion?

Otitis media with effusion (OME) is also known as serous otitis media or secretory otitis media (SOM). This condition occurs when non-infected fluid builds up in the middle of your ear. You may feel like something is stuck in your ear.

Otitis media with effusion is more likely to occur if you have a sore throat, upper respiratory infection, or cold.

It is estimated that around 80% to 90% of children will have one episode of otitis media with effusion before they reach school-age.

What Are Otitis Media With Effusion Causes?

Otitis media with effusion is primarily caused by dysfunction of the eustachian tubes, the pathways that connect your throat to the middle ear regions. The tubes also stabilize the pressure between your middle ear and the air. When a tube swells or is blocked, it restricts the normal drainage of your ear fluid from the middle ear. This results in the collection of the fluid behind the eardrum.

Factors causing eustachian tube dysfunction can also lead to otitis media with effusion. Some otitis media with effusion causes include:

  • An undeveloped eustachian tube in children
  • Inflamed adenoids, or lymphatic tissues in the back of the nose and the throat that can affect the speaking and breathing of children
  • Colds, allergies, or upper respiratory infections. These conditions can cause swelling or congestion in your nose, throat, or eustachian tube.
  • A structural defect in the formation of the eustachian tube.

What Are the Symptoms of Otitis Media With Effusion?

The signs and symptoms of OME usually vary from child to child. 

Some common otitis media with effusion symptoms include:

These symptoms are not always the result of otitis media with effusion; they may be the result of another underlying health condition.

What Is the Treatment for Otitis Media With Effusion?

Depending upon the severity of your child's condition, the doctor will recommend some treatment options. 

Monitoring

The fluid buildup in OME usually goes away within four to six weeks without any treatment. 

Medications

The OME fluid is not infected, so the doctor won't suggest antibiotics immediately. But if your child has any other infection apart from OME, they may prescribe you antibiotic medications. 

Most doctors avoid antihistamines and decongestants, as they have no significant impact on otitis media with effusion.

Ear Tubes or Myringotomy

Sometimes, the otitis media with effusion symptoms don't go away even after two or three months. It may affect their performance and development. In this case, the doctor may recommend a surgical procedure known as myringotomy. 

This surgery involves the insertion of ear tubes (myringotomy tubes). First, the surgeon makes a small hole in the eardrum to drain the fluid. Then, a small tube is placed in this opening to prevent fluid buildup in the future.

After the procedure, the child's hearing is restored, but it takes six to 12 months for the tubes to fall out on their own.

What Are Risk Factors of Otitis Media With Effusion?

Every child is at risk of developing otitis media with effusion symptoms, but some factors can increase your child's risk of developing them, including:

  • Having frequent colds
  • Spending most of their time in a day care setting
  • Being around a smoker
  • Lack of breastfeeding
  • Being bottle-fed while lying straight or on their back
  • Having a history of yearly or seasonal ear infections
  • Craniofacial dysfunction (e.g., cleft palate)

When Should You See a Doctor?

Ear infections can indicate potential underlying health issues. If you observe any otitis media with effusion symptoms, you should seek immediate help from a doctor. 

You should see a doctor when:

  • The symptoms don't go away after 24 hours.
  • Your child's age is less than six months. In this case, you should ask for prompt treatment.
  • Your child complains about unbearable ear pain.
  • You see any kind of fluid or pus coming out of your child's ears.
  • Your child faces difficulties sleeping due to respiratory infection or cold.

Show Sources

SOURCES:
Children's Hospital of Philadelphia: "Otitis Media with Effusion (OME)."
Columbia University Irving Medical Center: "Otitis Media (Middle Ear Infection) in Adults."
Mayo Clinic: "Ear Infection (Middle Ear)."
Medscape: "Otitis Media With Effusion."
Searight, F., Singh, R., Peterson, D., StatPearls: "Otitis Media With Effusion."
University of Michigan Clinical Care Guideline Ambulatory: "Otitis Media."
UpToDate: "Otitis Media With Effusion (Serous Otitis Media) in Children: Management."

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