Otitis media with effusion (ear infection)

Have you ever had otitis media with effusion? It’s an ear condition that is particularly prevalent among children aged up to 6 years old. While you may not have heard of it, it’s worth finding out about so you know the symptoms to watch out for and your treatment options.

What is otitis media with effusion?

Otitis media with effusion is an accumulation of fluid in your middle ear as a byproduct of an upper respiratory infection or cold. The fluid usually clears of its own accord within four to six weeks. However, in some cases, the fluid can remain for longer and cause a temporary loss of hearing or the fluid itself may become infected which is called acute otitis media. Its lack of obvious symptoms means it often goes undiagnosed unless it develops into acute otitis media.


Otitis media with effusion generally develops as a consequence of poor function of the eustachian tube (located between your middle ear and throat). The purpose of the eustachian tube is to balance the pressure between the air around you and the air within the middle ear. However, when it’s not working effectively, it stops the middle ear from draining fluid which can cause fluid to build up behind the eardrum.

The eustachian tube can stop working effectively for a number of reasons, including:

  • It’s an immature eustachian tube (common in young children)
  • The adenoids are inflamed
  • A cold or allergy had resulted in congestion and swelling of the lining of the nose, throat and eustachian tube
  • An abnormality of the eustachian tube

Risk factors for children

Children are more at risk of developing otitis media with effusion because of the shape of their eustachian tubes. These are much shorter in children, have small openings and are oriented horizontally, making it harder for fluid to drain out of the middle ear. This increases a child’s chance of clogging and infection. Additional risk factors that increase a child’s risk of developing otitis media with effusion include:

  • Having a cold
  • Having contact with someone who smokes
  • History of ear infections
  • Craniofacial abnormalities such as a cleft palate


Symptoms of otitis media with effusion can vary, but doesn’t usually involve a fever or pain, but can lead to a feeling of fullness in the ear and can involve some hearing loss. Other common symptoms can include:

  • Tugging or pulling at the ears
  • Loss of balance
  • Delayed speech development in children

For children, symptoms can largely depend on their age. But not every child with otitis media with effusion will have symptoms or show signs of being unwell.

Testing and diagnosis

If you suspect that either yourself or your child has otitis media with effusion, it’s important that you see your doctor. They will examine the ear using an otoscope, which is similar to a magnifying glass with a lighted end. The doctor will look for:

  • Air bubbles on the eardrum’s surface
  • Eardrum looks dull rather than shiny and smooth
  • There is visible fluid behind the eardrum
  • The eardrum doesn’t move even when a little air is blown on to it

Your doctor may also recommend you get your hearing checked which will help to diagnose whether you indeed have otitis media with effusion.

Treatments for otitis media with effusio

Otitis media with effusion will often clear up on its own without any intervention. However, chronic otitis media with effusion can increase your risk of getting ear infections. If it still feels like there is fluid behind your week after six weeks then you should see your doctor. It may mean you need more direct treatment to drain the fluid from your ears using ear tubes. If your child has adenoids, removing them may help treat and prevent it as adenoids can become enlarged and prevent ear drainage.

How to prevent otitis media with effusio

There are certain things you can do to reduce your risk of it developing.

  • Regularly wash hands and toys
  • Avoid being exposed to cigarette smoke
  • Avoid allergens
  • Use air filters to keep the air clean in your home
  • Only take antibiotics when necessary
  • Get the flu and pneumonia vaccines

Otitis media with effusion is very common and doesn’t usually cause any long-term damage. However, it’s still important to be vigilant, especially in young children. If you are concerned about otitis media with effusion, its symptoms and the impact on hearing, then speak to your doctor or licensed hearing care professional.

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