Otitis Media with Effusion

What Is Otitis Media with Effusion?

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

If you have OME, the middle part of your ear fills with fluid. It can increase the risk of ear infection.

OME is extremely common. According to the Agency of Healthcare Research and Quality, about 90 percent of children will have OME at least once by the age of 10.

What Causes OME?

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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 well-developed. This makes it harder for them to fight off ear infections that can lead to OME.

While OME isn’t 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. This 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 due to flying in an airplane or even by drinking while lying down.

A common misconception is that water in the ear can cause OME. This is untrue.

What Are the Symptoms of OME?

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Not all children with OME have symptoms. OME isn’t the result of an infection. Many children with OME don’t 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, behavior changes can be a sign of hearing problems. For example, children may turn the television up louder than usual. They may also tug or pull on their ears.

Older children and adults who have OME often describe sound as muffled. They may have the feeling that the ear is full of fluid.

How Is OME Diagnosed?

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A doctor 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 doesn’t 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 detect fluid in the middle ear.

How Is OME Treated?

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

If it feels like there’s fluid still lurking behind your ear after roughly six weeks, you may need to see your doctor 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.

How Can I Prevent OME?

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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:

  • frequently washing 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
  • breast-feeding, which helps your child resist ear infections
  • no drinking while lying down
  • 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.

What Are the Complications Associated with OME?

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OME isn’t associated with permanent hearing damage, even when fluid builds 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, causing hearing loss
  • affected speech or language delay

What Is the Long-Term Outlook for OME?

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Working closely with your doctor can help to minimize long-term symptoms. It’s particularly important to pay attention to hearing problems in young children. These can cause long-term language delays.

OME is very common and most often doesn’t cause long-term damage. If your child develops recurrent and frequent ear infections, consult with your doctor about ways to prevent further infections or OME.

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