Otitis Media With Effusion in Children (OME)

What is Otitis Media With Effusion in Children (OME)

Otitis media with effusion occurs when there is inflammation of the middle ear and fluid in the middle ear space. There are no signs and symptoms of infection. The middle ear space contains air and the bones for hearing. Air in the middle ear space helps to transmit sound to the brain.

OME is a common condition in children, and it often occurs after an ear infection. This condition may be present for several weeks or longer after an ear infection. Most cases of this condition get better on their own.

What are the causes?

OME is caused by a blockage of the eustachian tube in one or both ears. These tubes drain fluid in the ears to the back of the nose (nasopharynx). If the tissue in the tube swells up (edema), the tube closes. This prevents fluid from draining. Blockage can be caused by:

  • Ear infections.
  • Colds and other upper respiratory infections.
  • Allergies.
  • Irritants, such as tobacco smoke.
  • Enlarged adenoids. The adenoids are areas of soft tissue located high in the back of the throat, behind the nose and the roof of the mouth. They are part of the body’s natural defense (immune) system.
  • A mass in the nasopharynx.
  • Damage to the ear caused by pressure changes (barotrauma).

What increases the risk?

Your child is more likely to develop this condition if:

  • He or she has repeated ear and sinus infections.
  • He or she has allergies.
  • He or she is exposed to tobacco smoke.
  • He or she attends daycare.
  • He or she is not breastfed.

What are the signs or symptoms?

Symptoms of this condition may not be obvious. Sometimes this condition does not have any symptoms, or symptoms may overlap with those of a cold or upper respiratory tract illness.

Symptoms of this condition include:

  • Temporary hearing loss.
  • A feeling of fullness in the ear without pain.
  • Irritability or agitation.
  • Balance (vestibular) problems.

As a result of hearing loss, your child may:

  • Listen to the TV at a loud volume.
  • Not respond to questions.
  • Ask “What?” often when spoken to.
  • Mistake or confuse one sound or word for another.
  • Perform poorly at school.
  • Have a poor attention span.
  • Become agitated or irritated easily.

How is this diagnosed?

This condition is diagnosed with an ear exam. Your child’s health care provider will look inside your child’s ear with an instrument (otoscope) to check for redness, swelling, and fluid.

Other tests may be done, including:

  • A test to check the movement of the eardrum (pneumatic otoscopy). This is done by squeezing a small amount of air into the ear.
  • A test that changes air pressure in the middle ear to check how well the eardrum moves and to see if the eustachian tube is working (tympanogram).
  • Hearing test (audiogram). This test involves playing tones at different pitches to see if your child can hear each tone.

How is this treated?

Treatment for this condition depends on the cause. In many cases, the fluid goes away on its own.

In some cases, your child may need a procedure to create a hole in the eardrum to allow fluid to drain (myringotomy) and to insert small drainage tubes (tympanostomy tubes) into the eardrums. These tubes help to drain fluid and prevent infection. This procedure may be recommended if:

  • OME does not get better over several months.
  • Your child has many ear infections within several months.
  • Your child has noticeable hearing loss.
  • Your child has problems with speech and language development.

Surgery may also be done to remove the adenoids (adenoidectomy).

Follow these instructions at home:

  • Give over-the-counter and prescription medicines only as told by your child’s health care provider.
  • Keep children away from any tobacco smoke.
  • Keep all follow-up visits as told by your child’s health care provider. This is important.

How is this prevented?

  • Keep your child’s vaccinations up to date. Make sure your child gets all recommended vaccinations, including a pneumonia and flu vaccine.
  • Encourage hand washing. Your child should wash his or her hands often with soap and water. If there is no soap and water, he or she should use hand sanitizer.
  • Avoid exposing your child to tobacco smoke.
  • Breastfeed your baby, if possible. Babies who are breastfed as long as possible are less likely to develop this condition.

Contact a health care provider if:

  • Your child’s hearing does not get better after 3 months.
  • Your child’s hearing is worse.
  • Your child has ear pain.
  • Your child has a fever.
  • Your child has drainage from the ear.
  • Your child is dizzy.
  • Your child has a lump on his or her neck.

Get help right away if:

  • Your child has bleeding from the nose.
  • Your child cannot move part of her or his face.
  • Your child has trouble breathing.
  • Your child cannot smell.
  • Your child develops severe congestion.
  • Your child develops weakness.
  • Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.

Summary

  • Otitis media with effusion (OME) occurs when there is inflammation of the middle ear and fluid in the middle ear space.
  • This condition is caused by blockage of one or both eustachian tubes, which drain fluid in the ears to the back of the nose.
  • Symptoms of this condition can include temporary hearing loss, a feeling of fullness in the ear, irritability or agitation, and balance (vestibular) problems. Sometimes, there are no symptoms.
  • This condition is diagnosed with an ear exam and tests, such as pneumatic otoscopy, tympanogram, and audiogram.
  • Treatment for this condition depends on the cause. In many cases, the fluid goes away on its own.
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