Learn About Otitis Media with Effusion

What is the definition of Otitis Media with Effusion?

Otitis media with effusion (OME) is thick or sticky fluid behind the eardrum in the middle ear. It occurs without an ear infection.

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What are the alternative names for Otitis Media with Effusion?

OME; Secretory otitis media; Serous otitis media; Silent otitis media; Silent ear infection; Glue ear

What are the causes of Otitis Media with Effusion?

The Eustachian tube connects the inside of the ear to the back of the throat. This tube helps drain fluid to prevent it from building up in the ear. The fluid drains from the tube and is swallowed.

OME and ear infections are connected in two ways:

  • After most ear infections have been treated, fluid (an effusion) remains in the middle ear for a few days or weeks.
  • When the Eustachian tube is partially blocked, fluid builds up in the middle ear. Bacteria inside the ear become trapped and begin to grow. This may lead to an ear infection.

The following can cause swelling of the Eustachian tube lining that leads to increased fluid:

  • Allergies
  • Irritants (particularly cigarette smoke)
  • Respiratory infections

The following can cause the Eustachian tube to close or become blocked:

  • Drinking while lying on your back
  • Sudden increases in air pressure (such as descending in an airplane or on a mountain road)

Getting water in a baby's ears will not lead to a blocked tube.

OME is most common in winter or early spring, but it can occur at any time of year. It can affect people of any age. It occurs most often in children under age 2, but is rare in newborns.

Younger children get OME more often than older children or adults for several reasons:

  • The tube is shorter, more horizontal, and straighter, making it easier for bacteria to enter.
  • The tube is floppier, with a tinier opening that's easy to block.
  • Young children get more colds because it takes time for the immune system to be able to recognize and ward off cold viruses.

The fluid in OME is often thin and watery. In the past, it was thought that the fluid got thicker the longer it was present in the ear. ("Glue ear" is a common name given to OME with thick fluid.) However, fluid thickness is now thought to be related to the ear itself, rather than to how long the fluid is present.

What are the symptoms of Otitis Media with Effusion?

Unlike children with an ear infection, children with OME do not act sick.

OME often does not have obvious symptoms.

Older children and adults often complain of muffled hearing or a sense of fullness in the ear. Younger children may turn up the television volume because of hearing loss.

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What are the current treatments for Otitis Media with Effusion?

Most providers will not treat OME at first, unless there are also signs of an infection. Instead, they will recheck the problem in 2 to 3 months.

You can make the following changes to help clear up the fluid behind the eardrum:

  • Avoid cigarette smoke
  • Encourage infants to breastfeed
  • Treat allergies by staying away from triggers (such as dust). Adults and older children may be given allergy medicines.

Most often the fluid will clear on its own. Your provider may suggest watching the condition for a while to see if it is getting worse before recommending treatment.

If the fluid is still present after 6 weeks, the provider may recommend:

  • Continuing to watch the problem
  • A hearing test
  • A single trial of antibiotics (if they were not given earlier)

If the fluid is still present at 8 to 12 weeks, antibiotics may be tried. These medicines are not always helpful.

At some point, the child's hearing should be tested.

If there is significant hearing loss (more than 20 decibels), antibiotics or ear tubes might be needed.

If the fluid is still present after 4 to 6 months, tubes are probably needed, even if there is no major hearing loss.

Sometimes the adenoids must be taken out for the Eustachian tube to work properly.

Who are the top Otitis Media with Effusion Local Doctors?
Highly rated in
Pediatric Otolaryngology

SUNY Health Sciences Centers

Natalya Chernichenko, MD

376 6th Ave 
Brooklyn, NY 11215

Richard Rosenfeld is a Pediatric Otolaryngologist and an Otolaryngologist in Brooklyn, New York. Dr. Rosenfeld has been practicing medicine for over 38 years and is rated as an Elite doctor by MediFind in the treatment of Otitis Media with Effusion. He is also highly rated in 9 other conditions, according to our data. His top areas of expertise are Otitis Media with Effusion, Otitis, Swimmer's Ear, and Sinusitis. He is licensed to treat patients in New York. Dr. Rosenfeld is currently accepting new patients.

Highly rated in

Saitama Medical Center, Jichi Medical University

Kitamura, JP 11500

Yukiko Iino is in Kitamura, Japan. Iino is rated as an Elite expert by MediFind in the treatment of Otitis Media with Effusion. She is also highly rated in 5 other conditions, according to our data. Her top areas of expertise are Otitis Media with Effusion, Otitis, Cholesteatoma, and Granulomatosis with Polyangiitis.

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Highly rated in

University Medical Center Utrecht

Utrecht, UT, NL 

Roderick Venekamp is in Utrecht, Netherlands. Venekamp is rated as an Elite expert by MediFind in the treatment of Otitis Media with Effusion. He is also highly rated in 5 other conditions, according to our data. His top areas of expertise are Otitis, Otitis Media with Effusion, Ruptured Eardrum, and Sinusitis.

What is the outlook (prognosis) for Otitis Media with Effusion?

OME most often goes away on its own over a few weeks or months. Treatment may speed up this process. Glue ear may not clear up as quickly as OME with a thinner fluid.

OME is most often not life threatening. Most children do not have long-term damage to their hearing or speaking ability, even when the fluid remains for many months.

When should I contact a medical professional for Otitis Media with Effusion?

Call your provider if:

  • You think you or your child might have OME. (You should continue to watch the condition until the fluid has disappeared.)
  • New symptoms develop during or after treatment for this disorder.
How do I prevent Otitis Media with Effusion?

Helping your child reduce the risk of ear infections can help prevent OME.

Ear anatomy
Middle ear infection (otitis media)
What are the latest Otitis Media with Effusion Clinical Trials?
The Effects of Exosomes in Children With Adenoid Hypertrophy Accompanied by Otitis Media With Effusion
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Otitis Media Diagnosis and Treatment: Coherent Optical Detection of Middle Ear Disease
What are the Latest Advances for Otitis Media with Effusion?
Outcome of the 'waiting until spontaneous extrusion' strategy for long-term tympanostomy tube placement in children with cleft palate.
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Update on first African clinical trial on earpopper for the treatment of otitis media with effusion FCT/UATH/HREC/PR/330.
Who are the sources who wrote this article ?

Published Date: July 22, 2020
Published By: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Kerschner JE, Preciado D. Otitis media. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 658.

Pelton SI. Otitis externa, otitis media, and mastoiditis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 61.

Rosenfeld RM, Shin JJ, Schwartz SR, et al. Clinical practice guideline: Otitis media with effusion executive summary (update). Otolaryngol Head Neck Surg. 2016;154(2):201-214. PMID: 26833645 pubmed.ncbi.nlm.nih.gov/26833645/.

Schilder AGM, Rosenfeld RM, Venekamp RP. Acute otitis media and otitis media with effusion. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 199.