II. Definitions
- Otitis Media with Effusion (Serous Otitis Media)
- Retention of clear, transudate fluid in middle ear without signs of infection
III. Risk Factors
- Upper Respiratory Infection
- Acute Otitis Media (following resolution)
- Asthma
- Allergic Rhinitis
- Craniofacial disorders
- Thumb Sucking or Pacifier use
- Passive Smoke Exposure
IV. Symptoms
- Ear Pain
- Decreased Hearing
- Tinnitus
- Balance difficulty (uncommon)
-
Speech Delay or Language Delay
- See Speech and Language Disorders in Children
- May result in inattention, school behavioral disorders and poor school performance
V. Signs
- Dull grey, amber or red TM
- Bubbles or air fluid levels
- TM retracted and moves to negative pressure (Eustachian Tube Dysfunction)
- TM thickened and increased vascularity to opaque
- Hearing Loss (<30 DB)
- Tympanometry (if available)
- Images
VI. Course: Natural course following Otitis Media
- At 2 weeks: 70% have persistent effusion
- At 4 weeks: 40%
- At 2 months: 20%
- At 3 months: 10%
VII. Management
-
Hearing related support
- Maintain a close face-to-face distance when communicating
- Decrease background noise
- Use visual aids
- Classroom adjustments (child sitting close to front of class)
- Autoinflation with Nasal Balloon (e.g. Otovent)
- https://www.nice.org.uk/advice/mib59/resources/otovent-nasal-balloon-for-otitis-media-with-effusion-pdf-63499234925509
- May improve Hearing in short term
- Perera (2013) Cochrane Database Syst Rev 2013(5):CD006285 +PMID: 23728660 [PubMed]
- Webster Webster (2023) Cochrane Database Syst Rev 9(9):CD015253 +PMID: 37750500 [PubMed]
- Otolaryngology referral indications
- Persistent serous effusion >3 months
- Adhesive Otitis Media signs
-
Myringotomy and Tympanostomy Tube placement Indications
- See Tympanostomy Tube for indications
- Consider after 3 months of persistent effusion
- Measures shown to be not efficacious
- Avoid Decongestants
- Avoid Antihistamines
- Avoid Antibiotics
- Avoid mucolytics
- Avoid Leukotriene Receptor Antagonists
- Avoid Systemic Corticosteroids
- Consider Intranasal Corticosteroids if comorbid Allergic Rhinitis
- (2012) Presc Lett 19(2): 9
VIII. Complications
- Adhesive Otitis Media
- Fluctuating or persistent Hearing Loss
- May impact learning, behavior and longterm Hearing
IX. Resources
- (2023) NICE Guideline 233: Otitis Media with Effusion in under age 12
Images: Related links to external sites (from Bing)
Related Studies
| Concepts | Disease or Syndrome (T047) |
| MSH | D010034 |
| ICD10 | H65.9 |
| SnomedCT | 194262006, 80327007 |
| English | Serous otitis media, Serous Otitis Media, serous otitis media, serous otitis media (diagnosis), serous nonsuppurative otitis media, Otitis media serous, Otitis media serous NOS, Serous otitis media NOS, media otitis serous, Otitis media;serous, otitis media serous, Serous otitis media NOS (disorder), Serous otitis media (disorder), otitis; media, serous, Otitis Media, Serous, Otitis media, serous |
| Dutch | otitis media sereus, sereuze otitis media NAO, Otitis media met effusie, otitis; media, sereus, Otitis media, sereuze |
| French | Otite moyenne séreuse SAI, Otite moyenne séreuse |
| German | Otitis media seroes, Otitis media seroes NNB, Otitis media, seröse |
| Italian | Otite media sierosa NAS, Otite media sierosa |
| Portuguese | Otite média serosa, Otite média serosa NE, Otite Média Serosa |
| Spanish | Otitis media serosa, Otitis media serosa NEOM, Otitis Media Serosa, otitis media serosa, SAI (trastorno), otitis media serosa, SAI, otitis media serosa (trastorno), otitis media serosa |
| Japanese | 滲出性中耳炎ＮＯＳ, 滲出性中耳炎, ｼﾝｼｭﾂｾｲﾁｭｳｼﾞｴﾝ, ｼﾝｼｭﾂｾｲﾁｭｳｼﾞｴﾝNOS |
| Czech | Serózní otitis media NOS, Serózní otitis media, serózní otitis media, serózní zánět středního ucha |
| Hungarian | Otitis media serosus, Otitis media serosus k.m.n. |
