Treatment:

In otherwise healthy children, the first treatment is to change environmental factors, if possible. This includes:

• Avoiding cigarette smoke
• Encouraging breastfeeding for infants
• Reconsidering group day care

If the child has allergies, staying away from triggers (such as dust) can help.

Most often the fluid will clear on its own. You doctor may suggest waiting and watching to see if the condition worsens.

If the fluid is still present after 6 weeks, treatment might include:

• Further observation
• A hearing test
• A single trial of antibiotics (if not given earlier)

If the fluid is still present at 12 weeks, the child's hearing should be tested. If there is significant hearing loss (> 20 decibels), antibiotics or ear tubes might be appropriate.

If the fluid is still present after 4 - 6 months, tubes are probably needed even if there is no significant hearing loss. Laser myringotomy is a newer alternative to ear tube surgery.

Sometimes the adenoids must be removed to restore proper functioning of the Eustachian tube.

Expectations (prognosis):

Otitis media with effusion usually goes away on its own over a few weeks or months. Treatment may speed up this process. Glue ear may not clear as quickly as OME with a thinner effusion.

OME is usually not life threatening, but it may result in serious complications. If there is fluid in the middle ear, hearing will be affected. Hearing problems can interfere with language development in children. Any fluid that lasts longer than 8-12 weeks is cause for concern.

Complications:

• Acute ear infection
• Cyst in the middle ear
• Permanent damage to the ear with partial or complete hearing loss
• Scarring of the eardrum (tympanosclerosis)
• Speech or language delay

Note: Permanent hearing loss is rare, but the risk increases the more ear infections a child has.

Calling your health care provider:

Call your health care provider if:

• You suspect you or your child might have otitis media with effusion. Continue to monitor the condition until the fluid has disappeared.
• New symptoms develop during or after treatment for this disorder.