Otitis media with effusion

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Ear anatomy

Middle ear infection (otitis media)

Otitis media with effusion

Alternative Names:

OME; Secretory otitis media; Serous otitis media; Silent otitis media; Silent ear infection; Glue ear
Treatment:

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In otherwise healthy children, the first line treatment for OME is to adjust environmental factors if possible (encourage breast-feeding, avoid cigarette smoke, reconsider group day care). If allergies are present, avoiding the allergens can be effective (e.g., house dust). Most often the fluid will clear on its own, and suggested treatment might be either to wait and observe, or to try a single round of antibiotics.

If the fluid is still present after 6 weeks, treatment might include further observation, a hearing test, and/or a single trial of antibiotics (if not given earlier).

If the fluid is still present at 12 weeks, hearing should be tested. If there is significant hearing loss (> 20 decibels), antibiotics or ear tube placement (grommets) might be appropriate.

If the fluid is still present after 4 to 6 months, tubes are probably indicated even if there is no significant hearing loss. Laser myringotomy is a newer alternative to ear tube surgery.

Sometimes adenoid removal is necessary to restore proper functioning of the Eustachian tube.

Expectations (prognosis):

Otitis media with effusion usually resolves on its own over weeks or months. Treatment may accelerate this process. As long as fluid is present in the middle ear, hearing will be impaired. This can interfere with language development in children. The disorder is usually not a threat to life but may result in serious complications. Glue ear is less likely to clear in a timely fashion than OME with a thinner effusion.

It is normal to have OME (fluid) for several weeks following treatment of an acute ear infection.

Complications:

Temporary hearing loss
Permanent damage to the ear with partial or complete deafness
Speech or language delay
Cholesteatoma
Tympanosclerosis
Acute otitis media

Although fluid can go unnoticed, it can cause significant hearing problems in children. Any fluid that lasts longer than 8-12 weeks is cause for concern -- in children, hearing problems may cause speech to develop slowly. Permanent hearing loss is rare, but the risk increases the more ear infections a child has.
Calling your health care provider:

Call your health care provider if you suspect you or your child might have otitis media with effusion. Continue to monitor the condition until the fluid has disappeared.

Call your health care provider if new symptoms develop during or after treatment of this disorder.