Otitis Media With Effusion in Children and Adults
A Temporary Buildup of Fluid Affecting Hearing in Children and Adults
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Medically reviewed by Lyndsey Garbi, MD
Otitis media with effusion is a buildup of fluid behind the eardrum, sometimes called glue ear. It’s not an ear infection and doesn’t cause pain. The most prominent symptom is usually hearing loss. Acute otitis media with effusion resolves on its own within days or weeks, while chronic otitis media with effusion lasts three months or more. The condition is more common in children than adults, but it can happen to anyone.
This article will discuss otitis media with effusion (OME), including its causes and how it's diagnosed and treated.
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Why Do Adults Get Otitis Media With Effusion?
To understand otitis media with effusion, it’s helpful to know a bit about the anatomy of the ear. The eustachian tube connects the ear to the back of the throat. This tube allows fluid to drain into the throat so it doesn’t collect in the ear. OME happens when the eustachian tube becomes closed or blocked. When this occurs, fluid can’t drain, so it remains in the middle ear behind the eardrum.
OME is more common in children than adults. This is because children’s eustachian tubes are more horizontal, which makes drainage more difficult. As people grow, the tubes become longer and more angled, reducing the risk for otitis media with effusion.
In adults, certain risk factors increase the odds of having otitis media with effusion. These include:
Experiencing a cold, allergies or a sinus infection, all of which can cause the eustachian tubes to swell
Having large tonsils or adenoids, or a deviated septum, which can block the tubes
Having radiation therapy to the head or neck
Recent changes to air pressure, including flying or diving
Tumors
Head or neck surgery
Types of Otitis Media With Effusion
Otitis media with effusion is classified by how long it lasts. Usually, it resolves independently within four to six weeks and does not require treatment. This is known as acute OME. Chronic OME is when the condition lasts longer than three months.
Neither acute nor chronic otitis media with effusion is serious or life-threatening. They don’t require a trip to the emergency room. However, it’s important to see a healthcare provider if you or your child experiences changes in hearing. Especially in childhood, hearing loss can lead to speech delays and may impact social development.
Symptoms: How Does Otitis Media With Effusion Feel?
The most common symptoms of otitis media with effusion is pain. Otitis media with effusion is sometimes called glue ear because of the sensation that the thick fluid behind the ear can cause.
Some adults with otitis media with effusion will experience symptoms including:
A feeling of fullness in the ear
Popping or crackling noises in the ear
Mild pain or discomfort
Small changes to balance
Testing to Diagnose Otitis Media With Effusion
The first step to getting an OME diagnosis is seeing your primary care provider. They’ll look into your ear using a lighted tool called an otoscope. OME can make the eardrum look dull or with bubbles on its surface, and your provider may notice fluid behind the ear.
Your healthcare provider might then recommend a tympanometry, a test that can measure the thickness of the fluid behind the eardrum. The test is painless and involves a tool similar to an ear thermometer, which uses sound waves to measure the fluid in the ear.
In addition, your provider may suggest a hearing test to see if you’re experiencing hearing loss.
Treatment Options for OME
In most cases, OME doesn’t require treatment and will resolve on its own. However, chronic OME may need medical interventions. These can include:
Over-the-counter (OTC) medications like antihistamines to treat underlying conditions, like allergies, that may be causing OME
Hearing aids to help with hearing loss
Ear tubes to allow for better ventilation and drainage of the middle ear
Surgery to remove the adenoids or tonsils if they are contributing
You should never try to poke around in your ear to encourage drainage.
Most cases of OME resolve within four to six weeks without treatment. If you have chronic OME, you should work with your healthcare provider to identify the underlying causes—from sinus disease to tumors—that might be contributing to your chronic OME. Addressing these factors can clear up the fluid behind your ear drum.
Summary
Otitis media with effusion is a buildup of fluid behind the eardrum. It often doesn’t cause noticeable symptoms, but can lead to hearing loss that resolves when the fluid is no longer present. OME in adults is often linked to other health conditions, like allergies, sinus infection or tumors. Most cases of OME don’t require treatment, but it’s important to address any underlying health conditions that might be contributing to fluid behind your eardrum.