Does your child often ask, “What did you say?” Have you noticed that they seem uninterested in what you are saying, even when talking about things they would normally find exciting?
These symptoms may be caused by the presence of fluid in the ear, a condition medically known as otitis media with effusion.
If so, your child may be suffering from otitis media with effusion. Dr. Sofia Stamataki, Director of the ENT Department at Euroclinic Children’s Hospital, explains this condition.
What Is Otitis Media with Effusion?
Otitis media with effusion is a very common ear condition characterized by the accumulation of non-infected fluid in the middle ear space, behind the eardrum.
It occurs most frequently in children between 6 months and 4–5 years of age. The condition is more common during the autumn and winter months and is often underdiagnosed because it usually does not present with acute symptoms (unlike acute otitis media).
Otitis media with effusion is usually self-limiting, meaning that the fluid often resolves on its own within 4 to 6 weeks. However, in some cases the fluid may persist for a longer period, leading to temporary hearing loss or acute otitis media if the fluid becomes infected.
Causes
Otitis media with effusion is usually caused by dysfunction of the Eustachian tube, the canal that connects the middle ear to the nasopharynx. The Eustachian tube helps equalize the pressure between the outside air and the middle ear.
Some of the reasons why the Eustachian tube may not function properly include:
Although any child can develop otitis media with effusion, the following factors may increase the risk:
Symptoms of Otitis Media with Effusion
Although the signs and symptoms of otitis media with effusion may vary from child to child and differ in severity, common symptoms include:
The symptoms of otitis media with effusion may resemble those of other conditions or medical problems. Parents should always consult their pediatrician and subsequently a pediatric ENT specialist for an accurate diagnosis and discussion of the appropriate treatment options.
Tests and Diagnosis
If you suspect that your child may have otitis media with effusion, you should schedule an appointment with a pediatric ENT specialist.
During the appointment, the doctor will review your child’s medical history and perform a clinical examination. A tympanogram will also be carried out to confirm whether fluid is present behind the eardrum.
In addition, a hearing test (audiogram) may be performed to determine whether your child’s hearing has been affected.
The pediatric ENT specialist may also perform additional tests, such as endoscopy, to check for enlarged adenoids, which often coexist with this condition.
Treatment of Otitis Media with Effusion
The treatment of otitis media with effusion depends on several factors and is tailored to each individual child.
In most cases, the fluid resolves on its own within 4 to 6 weeks, and therefore no treatment is required.
Medication for Otitis Media with Effusion
In most cases, the fluid in the middle ear associated with otitis media with effusion is not infected, and therefore antibiotics are not indicated. However, if your child has an upper respiratory tract infection accompanying the condition, antibiotic treatment may be recommended. Corticosteroid nasal sprays may improve Eustachian tube function and consequently help resolve the condition. Antihistamines and decongestants have not been shown to be effective in treating otitis media with effusion.
Surgery (Ventilation Tubes / Myringotomy)
If your child has otitis media with effusion lasting longer than 3 months and there is concern that the associated hearing loss may affect speech development or school performance, your doctor may recommend the placement of ventilation tubes through a procedure called myringotomy. This surgical procedure involves creating a small opening in the eardrum under microscopic guidance, suctioning the fluid, and immediately relieving pressure in the middle ear. A small ventilation tube is then inserted into the eardrum opening to allow air to enter and ventilate the middle ear, preventing further fluid accumulation. The child’s hearing is usually restored immediately. The tubes generally fall out on their own after six to twelve months. In rare cases, the procedure may need to be repeated.
The procedure may also be combined with adenoid removal (adenoidectomy), as enlarged or chronically infected adenoids may contribute to the development and persistence of otitis media with effusion.
Complications of Otitis Media with Effusion
In some cases, otitis media with effusion may lead to longer-term complications such as:
If you have any questions regarding your child’s condition, consult a pediatric ENT specialist.
Contact us to schedule your appointment and receive the appropriate medical care and support.
