What Is Otitis Media With Effusion?
Otitis media with effusion (OME) is a medical condition characterized by effusion (collection) of sticky, non-infected, thick fluid in the middle ear behind the eardrum. It is also known as secretory otitis media. The cause of this fluid effusion in the middle ear may be a result of the common flu, sore throat, cold and cough, or upper respiratory tract infection.
It is usually a self-limiting condition. This means that the fluid accumulation usually gets resolved on its own within a period of four to six weeks. However, the fluid may remain for a longer duration of time and cause temporary hearing impairment. In some cases, the fluid may become purulent and infected. It is then known as acute otitis media.
Otitis media with effusion is found to be more commonly present in children between six months and years of age. Boys are affected more commonly than girls. The condition is more common during the fall and winter. The disease usually remains underdiagnosed because of the lack of appearance of clinical symptoms when compared to acute cases.
What Are the Causes of Otitis Media With Effusion?
Otitis media with effusion may usually be caused as a result of malfunctioning of the eustachian tube. A canal that joins the region of the middle ear with the throat region is known as the eustachian canal. Its main function is to equalize the ear pressure and prevent building-up of fluid inside the ear canal by maintaining fluid drainage.
Due to the poor functioning of this tube, it obstructs normal drainage of fluid from the middle ear. This causes a fluid build-up in the middle ear behind the eardrum. Some of the causes of the malfunctioning of the eustachian tube include:
-
An improperly developed (immature) eustachian tube. This condition is quite common among younger kids.
-
Adenoiditis (inflammation and swelling of the adenoids due to infection).
-
An allergy or cold can lead to inflammation, swelling, and blockage of the nasal, throat, and eustachian tube lining. This inflammatory swelling prevents the normal passage of air and fluids through the middle ear.
-
Eustachian tube malformations.
-
Chronic irritants such as smoking.
Some of the common predisposing risk factors that may accentuate the risk of developing otitis media with effusion in a child include:
-
Having a stuffy nose, cold, or chronic cough.
-
Children spend more time at a daycare center.
-
Babies that are bottle-fed while lying on their back.
-
Children who inhale passive smoke due to their surroundings.
-
Lack of breastfeeding experience.
-
History of chronic and persistent ear infections.
-
Facial abnormalities like cleft lip or cleft palate.
What Are the Clinical Signs of Otitis Media With Effusion?
The clinical signs and symptoms of otitis media with effusion vary among pediatric patients. They may vary from being mild to severe. Some of the common clinical symptoms include:
-
Hearing impairment.
-
A feeling of ear fullness.
-
Lack of mental balance.
-
Speech development is delayed.
-
Children may raise the television volume due to difficulty hearing.
-
Children may complain of ringing in the ears.
However, the children usually do not fall sick unless they suffer from an ear infection.
How to Diagnose Otitis Media With Effusion?
The condition can be diagnosed by a specialist doctor after the patient visits a doctor for an ear check-up. The healthcare professional will take the medical history of the patient and physically examine his ear.
The eardrum will be thoroughly examined by the doctor using an otoscope to detect certain changes, such as.
-
Air bubble formation on the eardrum surface.
-
Eardrum dullness when the light is passed through it.
-
When small puffs of air are blown at the eardrum, it does not appear to be moving.
-
Presence of fluid accumulation behind the eardrum.
Tympanometry tool is usually used by healthcare professionals to detect otitis media with effusion. It helps to evaluate the proper functioning of the middle ear. It is conducted by passing air through the inner, middle, and outer parts of the ear by creating differences in air pressure through the ear canal. The movement of the eardrum is then recorded. The test results can help find the fluid quantity and thickness in the ear. Hearing tests should also be conducted to check for hearing impairment.
What Is the Treatment of Otitis Media With Effusion?
Treatment of otitis media with effusion depends on various other factors and it varies from person to person. Initially, the doctors will not treat the condition if there are no prominent signs and clinical symptoms present. The patient will be followed up for another two to three months to diagnose the progress of the condition.
Certain instructions are recommended by the healthcare provider to drain the fluid accumulated behind the eardrum.
-
Avoid smoke or alcohol. Cigarette smoking should be prohibited.
-
Encourage breastfeeding among infants.
-
Avoid allergic reactions by staying away from certain triggering factors such as dust, pollen, etc. Certain antiallergic medications can also be given by the doctor to manage allergies in adults and children.
Usually, the fluid clears on its own. The healthcare provider may suggest rechecking the condition for another two to three months to see how it is progressing before suggesting treatment. Even if the fluid persists after six weeks, the healthcare provider may suggest:
-
Continuing rechecking the medical problem.
-
Conducting a hearing test.
-
Antibiotic dosage if not given previously.
If the fluid persists for 8 to 12 weeks, antibiotics will be given. However, these medications are not always useful. In the hearing test, if there is considerable hearing loss (greater than 20 decibels), eustachian tubes or antibiotic medications might be recommended by the doctor.
Even if there is no major loss of hearing but the fluid accumulation still persists after three to six months, ear tubes are then certainly required. The adenoids also require surgical removal in some cases for the proper functioning of the eustachian tubes.
What Is the Prognosis of Otitis Media With Effusion?
Usually, the prognosis of otitis media with effusion is good as the disease is self-limiting. It goes away over a period of a few weeks to months. Timely diagnosis and proper treatment can speed up the recovery of the patient. It is not a life-threatening condition.
Conclusion
Otitis media with effusion is a condition characterized by non-purulent fluid accumulation in the middle ear. It usually goes away on its own within a few weeks or months. If the fluid is thin, the condition will have a good prognosis. But if it is a glue ear (thick fluid), it will take time to resolve. It can be prevented by minimizing the risk of ear infections in children. Regular follow-ups are required by the doctor to check the worsening of the condition.
