Otitis media with effusion

Alternative Names

Treatment

In otherwise healthy children, the first line treatment involves changing environmental factors, if possible. This includes:

• Avoiding cigarette smoke
• Encouraging breastfeeding
• Reconsidering group day care

If the child has allergies, staying away from triggers (such as dust) can help.

Most often the fluid will clear on its own. You doctor may suggest waiting and watching to see if the condition worsens, or trying a single round of antibiotics.

If the fluid is still present after 6 weeks, treatment might include further observation, a hearing test, and a single trial of antibiotics (if not given earlier).

If the fluid is still present at 12 weeks, hearing should be tested. If there is significant hearing loss (> 20 decibels), antibiotics or ear tube placement (grommets) might be appropriate.

If the fluid is still present after 4 to 6 months, tubes are probably needed even if there is no significant hearing loss. Laser myringotomy is a newer alternative to ear tube surgery.

Sometimes adenoid removal is necessary to restore proper functioning of the Eustachian tube.

Outlook (Prognosis)

Otitis media with effusion usually goes away on its own over weeks or months. Treatment may speed up this process. Glue ear is less likely to clear in a timely fashion than OME with a thinner effusion.

OME is usually not a threat to life but may result in serious complications. As long as fluid is present in the middle ear, hearing will be affected. Hearing problems can interfere with language development in children. Any fluid that lasts longer than 8-12 weeks is cause for concern.

Possible Complications

• Acute ear infection
• Cyst in the middle ear
• Permanent damage to the ear with partial or complete hearing loss
• Scarring of the eardrum (tympanosclerosis)
• Speech or language delay

Note: Permanent hearing loss is rare, but the risk increases the more ear infections a child has.

When to Contact a Medical Professional

Call your health care provider if you suspect you or your child might have otitis media with effusion. Continue to monitor the condition until the fluid has disappeared.

Call your health care provider if new symptoms develop during or after treatment of this disorder.