Otitis Media with Effusion

Otitis media with effusion (OME), also known as serous otitis or glue ear, is characterized by accumulation of mucoid or serous fluid in the middle ear without acute signs of infection. It results from Eustachian tube dysfunction, viral upper respiratory infection, allergic rhinitis, adenoid hypertrophy, cleft palate, or as residual effusion after acute otitis media.

OME is the most common cause of pediatric hearing loss, affecting up to 90% of children at least once before school age. It produces conductive hearing loss of typically 25-30 dB, with potential consequences including delayed speech and language development, behavioral and academic problems, and balance disturbance. In adults, persistent unilateral OME requires evaluation for nasopharyngeal carcinoma.

Diagnosis is based on otoscopy showing a dull tympanic membrane with reduced mobility, air-fluid level or bubbles, and confirmed by tympanometry (type B or C curve). Most cases resolve spontaneously within 3 months. Watchful waiting is preferred initially. If effusion persists beyond 3 months with documented hearing loss, tympanostomy tube insertion (with or without adenoidectomy) is the treatment of choice. Antibiotics, antihistamines, decongestants and corticosteroids are not routinely recommended.