Middle ear fluid

What is middle ear fluid?

The build-up of fluid in the middle ear, also called otitis media with effusion, is a very common condition in children.

Normally, fluid drains easily out of the middle ear into the back of nose and throat through the Eustachian tube.

During colds and other upper respiratory infections, fluid commonly builds up in the middle ear. This fluid can get stuck in the middle ear when inflammation and swelling of the mucous membranes blocks the Eustachian tube.

An ear infection (acute otitis media) develops when viruses or bacteria infect this fluid. With otitis media with effusion, the fluid becomes thicker and stays in the middle ear after the upper respiratory infection (or ear infection) is gone. It is not known why some children are more likely to develop this condition than others.

However, this condition does tend to run in families, so a genetic link probably plays an important role.

Treatment / What you should do

After an ear infection, it usually is important to have your child's ears checked to make sure that fluid does not remain in the middle ear.

If you suspect that your child has recently developed hearing problems, you should also visit your doctor. The doctor will look inside the ear with a special tool called an otoscope. He will then be able to see the eardrum, evaluate its movement, and see whether or not there is fluid in the middle ear.

If there is fluid present, your doctor may recommend a decongestant to help drain the middle ear. In theory, these medications may improve the movement of fluid out of the middle ear through the Eustachian tube by reducing swelling of the mucous membranes in the area.

However, research suggests that these medications actually do little to help with middle ear fluid.

If this middle ear fluid does not disappear in 2-3 months, then the child should be referred to an ear-nose-throat (ENT) specialist, also called an otolaryngologist.

The specialist will decide whether the child should have small plastic tubes placed through the eardrum (ear tubes), which allow the fluid in the middle ear to drain normally.

Whether or not a child with middle ear fluid needs ear tubes, depends, in part, on how long the fluid has been there, how many infections the child has had, and whether or not hearing is being affected.

For most children, putting in ear tubes leads to fewer infections and helps hearing return to normal.

Ear tubes eventually fall out, so a doctor should monitor the position of the tubes regularly. Children with ear tubes should avoid getting water into the middle ear while bathing or swimming, as this can cause infection and ear drainage.