Fluid in the Middle Ear (Otitis Media with Effusion): What Is It?
Fluid accumulation in the middle ear, medically known as Otitis Media with Effusion (OME), is a condition characterized by the presence of fluid behind the eardrum. It often occurs without pain or fever and is most common in children.
- The most prominent symptom is hearing loss.
- In children, signs such as turning up the TV volume, not responding when called, or a drop in school performance may indicate hearing loss.
What Causes Fluid in the Middle Ear?
- Developmental differences in the Eustachian tube: In children, the horizontal position of the tube can lead to fluid buildup.
- Enlarged adenoids: May block the Eustachian tube and prevent fluid drainage.
- Immature immune system: Children are more prone to middle ear infections due to increased susceptibility to germs.
- Allergic rhinitis: Can contribute to fluid buildup in the middle ear.
- Viral upper respiratory infections: May lead to fluid accumulation in adults after a cold.
Unilateral and persistent middle ear fluid, especially when accompanied by a painless neck mass, should be evaluated for the possibility of a nasopharyngeal tumor.
How Is Middle Ear Fluid Diagnosed?
- Examination may reveal a dull, retracted eardrum or air bubbles behind it.
- Middle ear pressure testing (tympanometry) and hearing tests confirm the diagnosis.
Treatment Options
The first choice is medical treatment
- Antibiotics: May be prescribed for a 10–14 day course.
- Decongestant nasal sprays: Can help open the Eustachian tube.
- Antihistamine and corticosteroid sprays: Used in allergy-related cases.
Follow-up process
- Patients are monitored with regular checkups over the first 3 months.
- If there is eardrum retraction or significant hearing loss, earlier intervention may be required.
- If the fluid persists after 3 months, surgical treatment (insertion of ventilation tubes) may be considered.
Conclusion
If not detected early, fluid in the middle ear can lead to permanent hearing loss. With regular doctor visits and appropriate treatment, it is a condition that can largely be resolved.
Prof. Dr. Elif Aksoy
ENT Specialist – Pediatric and Adult Ear Disorders
