Otitis media with effusion (OME) is a collection of non-infected fluid in the middle ear space. It is also called serous or secretory otitis media (SOM). This fluid may accumulate in the middle ear as a result of a cold, sore throat or upper respiratory infection.
OME is usually self-limited, which means, the fluid usually resolves on its own within 4 to 6 weeks. However, in some instances the fluid may persist for a longer period of time and cause a temporary decrease in hearing or the fluid may become infected (acute otitis media).
While any child may develop OME, the following are some of the factors that may increase your child's risk of developing OME:
OME is usually a result of poor function of the eustachian tube, the canal that links the middle ear with the throat area. The eustachian tube helps to equalize the pressure between the air around you and the middle ear.
When this tube is not working properly, it prevents normal drainage of fluid from the middle ear, causing a build up of fluid behind the eardrum.
The following are some of the reasons that the eustachian tube may not work properly:
The following are the most common symptoms of OME. However, each child may experience symptoms differently. Symptoms may include:
The symptoms of OME may resemble other conditions or medical problems. Always see your child's physician for a diagnosis.
In addition to a complete medical history and physical examination, your child's physician will inspect the outer ear(s) and eardrum(s) using an otoscope. The otoscope is a lighted instrument that allows the physician to see inside the ear. A pneumatic otoscope blows a puff of air into the ear to test eardrum movement.
A hearing test may be obtained in children who have OME. The hearing levels and the findings on tympanometry may help to diagnose OME.
The specific treatment for this condition depends on many factors and is tailored for each child. Please discuss your child's condition, treatment options and your preferences with your child's physician or healthcare provider.
Treatment may include:
This surgical procedure involves making a small opening in the eardrum to drain the fluid and relieve the pressure from the middle ear. A small tube is placed in the opening of the eardrum to allow air to enter (ventilate) the middle ear and to prevent fluid from accumulating. The child's hearing is restored after the fluid is drained. The tubes usually fall out on their own after six to twelve months.
Your child's surgeon may also recommend the removal of the adenoids (lymph tissue located in the space above the soft roof of the mouth, also called the nasopharynx) if they are infected. Removal of the adenoids has been shown to help some children with OME.
Treatment will depend upon the type of otitis media. Consult your child's physician regarding treatment options.
For more information, refer to the following resources from AAO-NHS:
In addition to the symptoms listed above, otitis media with effusion can also result in any or all of the following:
Reviewed by: Steven D. Handler, MD, MBE
Date: April 2009