Fluid in the ear Outline

MEDICAL TERM
Serous Otitis Media, Otitis Media with Effusion

CAUSES
Many children get fluid in the ear after a cold, ear infection or allergies.

AGE
Most common—infant to ten years old.

SYMPTOMS

• Blocked ear
• No complaints
• Hearing loss

Frequently the child will have no complaints but may start having trouble in school or difficulty hearing the television, radio, iPod, etc. In the younger child speech delays and learning difficulties may be present.

PHYSICAL EXAM

• Ear drum—dull, retracted, yellowish hue
• Immobile drum—drum will not move when using a pneumonic otoscopy. This should only be performed by a doctor.
• Air fluid level or air bubbles

When fluid has been present for a long period it can become very thick and looks like mucous (NOTE: See the section on Glue Ear for a description of long standing fluid in the ear.)

LAB

• Conductive hearing loss
• Type B or C tympanogram

TREATMENT

• Decongestants/antihistamine
• Antibiotics
• Middle ear ventilation tubes (Pneumatic Equalizing tubes or P.E. tubes)

The middle ear fluid will clear in most children in a period of 6 to 12 weeks.

REFERRAL
If a child fails a tympanogram during school or other screening the child should be tested again in 2 to 3 weeks. This follow-up test is especially necessary if a child has a cold. If the fluid is still present then the child should be referred for treatment.

PREVENTION
Minimize exposure to colds and flu, identify and treat allergies, teach children to “pop” their ears. (See appendix 1)