Otitis Media with Effusion

Written by Rachel Nall | Published on July 17, 2012
Medically Reviewed by George Krucik, MD

What Is Otitis Media With Effusion?

Normally, the Eustachian tube drains fluid from your ears to the back of your throat. If it becomes clogged, otitis media with effusion (OME) can occur.

If you have OME, the middle part of your ear is filled with fluid. It can increase the risk of ear infections.

OME is extremely common. According to the American Academy of Family Physicians, approximately 90 percent of children will have OME at least once before they begin school. (Pediatrics)

What Are the Symptoms of OME?

Not all children with OME have symptoms. OME is not caused by an infection. Therefore many children with OME do not act or feel sick.

Symptoms are often mild or minimal. They can vary based on the child’s age.

One common symptom of OME is hearing problems. In younger children, these can be detected through behavior changes. For example, children may turn the television up louder than usual. They may also tug or pull on their ears.

For older children and adults who have OME, sound is often described as muffled. There may be the feeling that the ear is filled with fluid.

What Causes OME?

Children are more likely to experience OME due to the shape of their ear tube. Their tubes are shorter and have smaller openings. This increases the risk of clogging and infection. In addition, children’s immune systems may not be as well developed. This makes it harder for them to fight off ear infections that can lead to OME.

While OME is not an ear infection, the two can be related. For example, an ear infection can affect how well fluid flows through the middle ear. Even after the infection is gone, fluid may remain.

In addition, a blocked tube and excess fluid can provide the ideal environment for bacteria to grow. Therefore OME can lead to an ear infection.

Allergies, air irritants, and respiratory infections can all cause OME. Changes in air pressure can close the Eustachian tube and affect fluid flow. These might be caused by being on an airplane or even by drinking while lying down.

A common misconception about OME is that it is caused by water in the ear. This is untrue.

How Is OME Diagnosed?

A physician will examine the ear using an otoscope. This magnifying glass has a lighted end for looking inside the ear.

The doctor will be looking for:

  • air bubbles on the eardrum’s surface
  • an eardrum that appears dull instead of smooth and shiny
  • visible fluid behind the eardrum
  • an eardrum that does not move when a small amount of air is blown into it

More sophisticated testing methods are available. One example is tympanometry. This test inserts a probe into the ear. It determines how much fluid is behind the eardrum and how thick it is.

An acoustic otoscope can also be used to detect fluid in the middle ear.

How Is OME Treated?

OME often clears up on its own. However, chronic OME can increase your risk of ear infections. Therefore, your physician may recommend taking a low-dose antibiotic if you or your child is prone to frequent ear infections.

If you feel as if the fluid is still lurking behind your ear after roughly six weeks, you may need to see your physician again. You may need more direct treatment to drain your ears.

One form of direct treatment is ear tubes. These help drain fluid from behind the ears.

Removing the adenoids can also help treat or prevent OME. When enlarged, adenoids can block ear drainage.

Tips to Prevent OME

OME is most likely to occur in the fall and winter months, according to the Children’s Hospital of Pennsylvania (CHOP). Fortunately, there are things you can do to reduce your risk of developing OME.

Preventive techniques include:

  • frequent washing of hands and toys
  • avoiding cigarette smoke and pollution, which can affect ear drainage
  • avoiding allergens
  • using air filters to keep air as clean as possible
  • utilizing a smaller day care center, ideally with six children or fewer
  • breastfeeding, which helps your child resist ear infections
  • taking antibiotics only when necessary

The pneumonia and flu vaccines also may make you less vulnerable to OME. They can prevent the ear infections that increase OME risk.

Complications and Long-Term Effects of OME

OME is not associated with permanent hearing damage, even when fluid is built up for some time. However, if OME is associated with frequent ear infections, more complications can occur.

These can include:

  • acute ear infections
  • cysts in the middle ear
  • eardrum scarring
  • damage to the ear that causes hearing loss
  • affected speech or language delay

Working closely with your doctor can help to minimize long-term symptoms.

It is particularly important to pay attention to hearing problems in young children. These can cause long-term language delays.

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