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Otitis Media with Effusion - Fluid in the Ears

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Updated May 28, 2014

Ear examination. Otoscope being used by a general practice doctor to examine a one-year-old boy's ear. This instrument is used to magnify and illuminate the interior of the ear.
Science Photo Library - ADAM GAULT/Brand X Pictures/Getty Images

If you have ever been to the doctor and been told you have fluid in your ears, you have probably had otitis media with effusion (OME). This simply means there is fluid in the ear, but no acute infection. It is common, especially in children, after an ear infection has cleared up. OME occurs most often in children under the age of 2, but can occur at any age.

What Causes Fluid in the Ears

Children most frequently get fluid in their ears due to having short Eustachian tubes. These tubes, which are part of the anatomy of the middle ear, allow fluid to drain out of the ear and down the throat. However, in children, the tubes are often short, more horizontal and may be partially blocked by large adenoids. When this is the case, fluid tends to back up and stay in the tube instead of draining like it should.

Symptoms

Most children do not show any symptoms when they have fluid in the ears. It is not painful and does not cause a fever. Some symptoms you may notice include:

  • Older children or adults complain of popping or fullness in the ear
  • Younger children turn up the volume on the tv or are less responsive to soft noises

However, most cases of OME are diagnosed when a healthcare provider is examining the ear for another reason, such as a routine check up or a follow up from a previous ear infection.

Treatment Options

Typically, treatment is not necessary for fluid in the ears. The fluid will usually drain on its own within a few weeks. However, if it does not, treatment depends on several factors.

  • If the fluid is present for 6 weeks, treatment may include a hearing test, a round of antibiotics or further observation.
  • If the fluid is present after 12 weeks, a hearing test should be performed. If there is significant hearing loss, the health care provider may consider antibiotics or placing tubes in the ears.
  • If the fluid is still present after 4 to 6 months, tubes are probably necessary even without hearing loss.
  • Adenoids may also need to be removed if they are large and causing significant blockage of the Eustachian tube.

Preventing Fluid in the Ears

  • Avoid cigarette smoke
  • Identify any allergens that may lead to OME and attempt to avoid them
  • If your child is in daycare, consider taking him out or switching to a smaller daycare if he gets fluid in his ears frequently
  • Wash your hands and your child’s toys frequently
  • Avoid overusing antibiotics
  • Encourage breastfeeding if possible, even for just a few weeks. Infants who are breastfed get sick less often and are less likely to get ear infections even years later.
  • Stay up to date on vaccines. The pneumococcal vaccine (Prevnar) helps prevent the most common type of ear infections and the flu vaccine may help as well.

Contrary to popular belief, getting water in a baby or young child’s ears, will not cause OME. Children who swim frequently and do not dry their ears adequately may get otitis externa -- or swimmer’s ear -- but this is a completely different condition.

Complications

Usually, fluid in the ears does not lead to any serious complications. However, there are a few to watch out for.

Source:

”Otitis Media With Effusion.” Medical Encyclopedia 14 Nov 07. US National Library of Medicine. National Institutes of Health. 12 Feb 09.

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