Fluid in the Ear (Middle Ear Effusion)

Small amounts of fluid are normally produced in the middle ear (behind the ear drum). This fluid usually drains out of the ear through the eustachian tube, which connects the middle ear to the back of the nose.

A middle ear effusion occurs when fluid builds up in the space behind the eardrum. This fluid can cause problems in children. This condition is called middle ear effusion, otitis media with effusion or serous otitis media.

This condition does not usually cause pain. It happens most often after an ear infection (otitis media) but can also happen without a preceding infection. It tends to go away by itself but if your child has certain symptoms, then you will need to see a doctor.

Fluid in the ear is common, especially in children aged 2 years and younger. It is rare after age 8. Approximately 90% of children will have fluid in the ear at least once before they begin school, according to the American Academy of Family Physicians.

Patients can be seen by Texas Children's experts in Ear Nose and Throat (Otolaryngology).

Causes & Risk Factors

Causes include:

About 10% of children will still have fluid in the ear 3 months after the infection clears up.

Risk factors include:

  • Frequent ear infections
  • Frequent colds
  • Having cleft palate

Symptoms & Types

If your child has certain symptoms, an examination by a doctor is needed. Symptoms include:

  • Hearing problems
  • Unresponsiveness or inattentiveness
  • Tugging or pulling on the ear
  • Muffled sounds

Diagnosis & Tests

The doctor will use an instrument with a light attached (otoscope) to look into the ear canal for blockage or infection. The doctor may also recommend you have your child's hearing checked or refer you to an otolaryngologist (ear, nose and throat specialist).

Treatment & Care

This condition most often clears up on its own within 4 to 6 weeks. Antibiotics are not needed unless your child also has an upper respiratory infection.

If the condition lasts longer than 2 or 3 months, your child may need to have tubes put in the ears. This procedure is done under general anesthesia. A surgeon places a small drainage tube through the eardrum to help fluid drain. Hearing should improve right away.

Living & Managing

Most of the time, fluid in the ears goes away on its own. As your child grows, the eustachian tube also grows, which means fluid will have more space to drain from the ear.

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