Symptoms of Pediatric Ear Fluid

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

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.

Sourced from NIH

Causes of Pediatric Ear Fluid

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.

Allergies, irritants (particularly cigarette smoke), and respiratory infections can cause swelling of the Eustachian tube lining that leads to increased fluid.

Drinking while lying on your back and sudden increases in air pressure (such as descending in an airplane or on a mountain road) can cause the Eustachian tube to close or become blocked. 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.

Sourced from NIH

Diagnosis of Pediatric Ear Fluid

The health care provider may find OME while checking your child's ears after an ear infection has been treated.

The provider will examine the eardrum and look for certain changes, such as:

• Air bubbles on the surface of the eardrum
• Dullness of the eardrum when a light is used
• Eardrum that does not seem to move when little puffs of air are blown at it
• Fluid behind the eardrum

A test called tympanometry is an accurate tool for diagnosing OME. The results of this test can help tell the amount and thickness of the fluid.

The fluid in the middle ear can be accurately detected with:

• Acoustic otoscope
• Reflectometer: A portable device

An audiometer or other type of formal hearing test may be done. This can help the provider decide on treatment.

Sourced from NIH

Summary of Pediatric Ear Fluid

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

Symptoms: 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.

Causes: 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.

Allergies, irritants (particularly cigarette smoke), and respiratory infections can cause swelling of the Eustachian tube lining that leads to increased fluid. Drinking while lying on your back and sudden increases in air pressure (such as descending in an airplane or on a mountain road) can cause the Eustachian tube to close or become blocked. Getting water in a baby's ears will not lead to a blocked tube.

Diagnosis: The health care provider may find OME while checking your child's ears after an ear infection has been treated. The provider will examine the eardrum and look for certain changes. A test called tympanometry is an accurate tool for diagnosing OME, and can help determine the amount and thickness of the fluid. The fluid in the middle ear can be accurately detected with an acoustic otoscope or a reflectometer. An audiometer or other type of formal hearing test may be done to help the provider decide on treatment.

Treatments: The world's leading experts favor Watchful Waiting (79%-90% effective) for most children with otitis media with effusion and only recommend placing Ear Tubes (71% effective) in children with certain specific conditions. Autoinflation with Watching Waiting may also be considered.