Otitis media with effusion

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Ear anatomy

Middle ear infection (otitis media)

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

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.

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.

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

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.

Review Date: 05/10/2006
Reviewed By: Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, Associate Professor of Pediatrics, NYU School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.