Otitis media with effusion

Otitis media with effusion (OME; also known as glue ear) typically presents with hearing loss, ear pressure or discomfort, or ear blockage without symptoms of acute infection. In children, symptoms attributable to OME may also include poor balance, poor school performance, and behavioural problems.

Both children and adults may be asymptomatic.

Perform an examination of the ears, including pneumatic otoscopy where possible, to detect reduced tympanic mobility, which may be the only sign of effusion in a patient with OME. On standard otoscopy, the tympanic membrane may appear dark, with an amber, grey, or blue hue. There may be bubbles or an air-fluid level.

Treatment of OME entails watchful waiting or surgical intervention with tympanostomy tube placement (with or without adenoidectomy) depending on the duration of effusion, the presence and/or severity of symptoms, and the risk of developmental sequelae.

​OME is defined as the presence of fluid in the middle ear, without any associated signs of ear infection.[1]Simon F, Haggard M, Rosenfeld RM, et al. International consensus (ICON) on management of otitis media with effusion in children. Eur Ann Otorhinolaryngol Head Neck Dis. 2018 Feb;135(1s):S33-9. https://www.sciencedirect.com/science/article/pii/S187972961830005X http://www.ncbi.nlm.nih.gov/pubmed/29398506?tool=bestpractice.com ​[2]Rosenfeld RM, Shin JJ, Schwartz SR, et al. Clinical practice guideline: otitis media with effusion (update). Otolaryngol Head Neck Surg. 2016 Feb;154(1 suppl):S1-41. https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1177/0194599815623467 http://www.ncbi.nlm.nih.gov/pubmed/26832942?tool=bestpractice.com ​ It is differentiated from acute otitis media by the absence of symptoms of infection. It may be known colloquially as ear fluid or ‘glue ear’. Chronic OME is defined as OME that persists for 3 months or longer from the date of onset if known, or from the date of diagnosis.[1]Simon F, Haggard M, Rosenfeld RM, et al. International consensus (ICON) on management of otitis media with effusion in children. Eur Ann Otorhinolaryngol Head Neck Dis. 2018 Feb;135(1s):S33-9. https://www.sciencedirect.com/science/article/pii/S187972961830005X http://www.ncbi.nlm.nih.gov/pubmed/29398506?tool=bestpractice.com [2]Rosenfeld RM, Shin JJ, Schwartz SR, et al. Clinical practice guideline: otitis media with effusion (update). Otolaryngol Head Neck Surg. 2016 Feb;154(1 suppl):S1-41. https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1177/0194599815623467 http://www.ncbi.nlm.nih.gov/pubmed/26832942?tool=bestpractice.com

This topic focuses on the paediatric population. Information that pertains to adults is explicitly stated throughout.