Fluid behind the eardrum is known in Medicine as Otitis media with effusion. It is a common condition that affects anyone, regardless of the age. However, children are more likely to suffer from Otitis media with effusion than adults. In adults the condition is more likely to be chronic and last for a long period of time. It is more likely to occur during winter. Otitis media with effusion in most of the cases follows the acute otitis media. However, middle ear effusions can occur without preceding acute otitis media. The fluid collected in the middle ear is usually a non-purulent, serous or mucoid fluid.
The Eustachian tube and its functions
The Eustachian tube has three major functions in the human body:
• Equilibration of pressure between the external and middle ear,
• Secretion and cleansing,
• Protection of the middle ear.
Normally, the role of the Eustachian tube is to drain the fluid from the ears to the back of the throat. If, for any reason this tube is blocked, there will be no drainage of the fluid or the drainage will be impaired and otitis media with effusion will occur. The fluid accumulates in the middle ear and it can occur in one or both ears. It can last from couple of days to couple of weeks.
As mentioned before, children are more likely to suffer from this condition, mostly due to the shape of their Eustachian tube. It has been estimated that 9 in 10 children will have otitis media with effusion at least once, before the age of 10. The reason is that the Eustachian tube in children is shorter and the openings are smaller, which will lead to clogs and infections. While otitis media with effusion is not an infection, it can be also accompanied with an infection of the middle ear. It is well known that infections of the ear will impair the ability of the fluid to drain. When the fluid is not drained properly it will get collected in the middle ear, even after the infection is gone.
Any change in the air pressure can also close the Eustachian tube, affecting the flow of the fluid from the ear. This can be due to barotrauma, like in cases when flying in an airplane. Drinking fluids while lying down also may change the air pressure and close the Eustachian tube.
Otitis media with effusion has also been linked with allergy or upper respiratory tract infections.
What are the signs and symptoms of Otitis Media with Effusion?
The signs and symptoms of otitis media with effusion may vary. In many cases there are no signs and symptoms at all. However, typical signs and symptoms that are associated with otitis media with effusion include:
– A sensation of having the ear filled with fluid
– Aural fullness
– Hearing loss
– A sensation of a foreign body within the ear.
In rare cases adults suffering from otitis media with effusion have reported acute ear pain.
How is Otitis Media with Effusion diagnosed?
Your health care provider will examine your ear using an otoscope. With the help of an otoscope, your doctor will be able to examine the inside of the ear and he/she will be looking for:
• air bubbles on the eardrum surface
• fluid behind the eardrum that is visible
• an eardrum that is dull instead of smooth and shiny
• an eardrum that does not move when air is blown into it.
With the help of tympanometry, which is another examination method, your doctor is able to determine the amount of fluid that is behind your eardrum, but also its thickness.
Occasionally, a tonsillar hypertrophy is also found in accompany with otitis media with effusion. More commonly, an adenoid hypertrophy is present, especially in cases when the condition is prolonged over a long period of time and when it re occurs over the time.
How is Otitis Media with Effusion treated?
In many cases no treatment is required as the condition resolves on its own. However, in cases with chronic otitis media with effusion there is a greater risk for developing an infection. In these cases antibiotics are prescribed and it is very important to take them as your doctor has advised you. If the condition does not get better after 6 weeks, you should seek medical help again and get a new evaluation. In some cases a more direct treatment is necessary in order to drain the fluid from your ear. Ear tubes are also often recommended in cases with chronic otitis media with effusion. These ear tubes help drain the fluid from behind the ears. In some cases the surgical removal of adenoids is also recommended, when the drainage is impaired due to the blockage of enlarged adenoids.
If not treated correctly otitis media with effusion can lead to various complications, like:
• Acute ear infections
• Scarring of the eardrum
• Damage to the ear with can also lead to hearing loss
• Cysts in the middle ear
• Language delay or affected speech
Keep in mind that although this disorder is usually painless, the fluid often impairs hearing. Hearing may be impaired sufficiently to affect the understanding of speech, language development, learning, and behavior.