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Patient Information
Table 8. Frequently Asked Questions: Understanding Ear
Fluid
Question Answer
What is ear fluid
and how common
is it ?
Ear fluid, also called otitis media with effusion (OME), is a build-
up of mucus or liquid behind the eardrum, without symptoms of
an ear infection. Nearly all children get ear fluid at least once by
school age.
How does ear fluid
differ from an ear
infection?
Ear infections (acute otitis media [AOM]) occur when germs
(bacteria and/or viruses) enter the middle ear and cause fever,
ear pain, and active (acute) inflammation. Both AOM and OME
have fluid in the middle ear, but with OME the fluid is not
actively infected and pain may be absent or minimal.
If my child gets
ear fluid, how can
I tell?
You might not be able to tell. Some children with OME have
obvious hearing problems, but other children may have no
symptoms at all or more subtle findings (e.g., ear rubbing,
clumsiness, selective hearing, disturbed sleep). Your doctor
can detect ear fluid by looking in the ear canal (otoscopy) or by
measuring the movement of the eardrum (tympanometry or
pneumatic otoscopy).
What causes ear
fluid?
OME may be caused by a cold, an ear infection (AOM), or by
the normal congestion (negative pressure) that many young
children have in their middle ear. Oen OME is detected during
a routine doctor's visit and the exact cause is unknown.
Should I worry if
my child has ear
fluid?
Most fluid goes away on its own in weeks or months, especially
if it was caused by a cold or an ear infection. OME is of more
concern if it lasts more than 3 months or when your child has
other problems that could be made worse by persistent ear fluid
(e.g., delays in speech, language, learning, or development). Your
doctor should check the ears periodically until the fluid is gone.
What is the best
way to manage ear
fluid?
ere are many opinions about managing OME, but the best
advice can be found in clinical practice guidelines, which
make recommendations based on best available evidence and
by considering the potential benefits and harms of different
strategies.