Otitis Media with Effusion

Medically reviewed by Karen Gill, MD on November 20, 2017Written by Rachel Nall on November 20, 2017

What is otitis media with effusion?

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, which can increase the risk of ear infection.

OME is very 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?

Children are more likely to experience OME due to the shape of their eustachian tubes. Their tubes are shorter and have smaller openings. This increases the risk of clogging and infection. Children’s eustachian tubes are also oriented more horizontally than in adults. This makes it more difficult for fluid to drain from the middle ear. And children have more frequent colds and other viral illnesses that can set them up for more fluid in the middle ear and more ear infections.

OME isn’t an ear infection, but they 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.

Also, 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 causes might be due to flying in an airplane or 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?

OME isn’t the result of an infection. Symptoms are often mild or minimal, and can vary based on a child’s age. But not all children with OME have symptoms or act or feel sick.

One common symptom of OME is hearing problems. In younger children, behavior changes can be a symptom of hearing problems. For example, a child 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. And they may have the feeling that the ear is full of fluid.

How is OME diagnosed?

A doctor will examine the ear using an otoscope, which is a magnifying glass with a lighted end used 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. For this test, a doctor inserts a probe into the ear. The probe 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?

OME often clears up on its own. However, chronic OME can increase risk of ear infections. You may need to see your doctor if it feels like there’s still fluid behind your ear after six weeks. You may need more direct treatment to drain your ears.

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

Removing the adenoids can also help treat or prevent OME in some children. When adenoids become enlarged they can block ear drainage.

How can I 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:

  • 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
  • breastfeeding, which helps your child resist ear infections
  • not 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?

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, other complications can occur.

These can include:

What is the long-term outlook for OME?

OME is very common and usually doesn’t cause long-term damage. However, if your child develops recurrent and frequent ear infections, consult your doctor about ways to prevent further infections or OME. It’s important to pay attention to hearing problems in young children as these can cause long-term language delays.

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