The fluid in the ear is called SOM( serous otitis media ) or OME(otitis media with effusion). It is fluid accumulation behind the eardrum which occurs under any condition and the auditory tube is impaired.
The fluid drains from the ear into the back of the throat by auditory tube. If this auditory tube gets clogged, fluid gets trapped in the Middle ear space. This fluid is then called effusion.
Besides ear infections, the common cold and allergy can also lead to fluid in the ear if mucus or inflammation prevent the auditory tube from draining.
Here we will see what else causes accumulation, how to prevent it and how to diagnose and treat it.
Some of the Common Causes are -
Anyone of any age can get fluid in the ears, but more likely it occurs in children due to anatomy of their auditory tube. It is smaller in diameter and more horizontal than the adult’s auditory tube.
About 2.2 million cases in the US are reported of otitis media with effusion each year, about 90 out of hundred children get fluid in the ears before they reach 5 to 6 years of age. All these cases of ear fluid are caused by some auditory tube dysfunction which prevents the eustachian tube from draining adequately.
The common causes of developing ear fluid for both adults and children include –
Enlarged sinus tissue, tonsils, adenoids, nasal polyps or other growths blocking the auditory tube.
Congestion, similar infection, from cold virus, or even pregnancy.
Chemical irritants especially smoke from cigarettes.
Radiation for head and neck cancer or any previous surgery which transect the auditory tube.
Rapid air pressure changes which occurs when flying in an airplane or scuba diving called barotrauma to the ears.
Oral abnormality associated with cleft palate or down syndrome.
Symptoms of ear fluid range in severity by individuals. In small children the condition is said to be symptomless, it is more likely children of this age are unable to express the discomfort. If there is no severe pain, the symptoms are unnoticed by their caretakers.
Most adult fluid in the Middle ear symptoms may be subtle , but some people get constant ear pain and debilitating symptoms. Older children and some adults who faced persistent problems with chronic fluid in the ears can tell if the fluid has re – accumulated and they need treatment.
In general symptoms of ear fluid may include-
Pain in the ear.
Feeling like ears are plugged up.
Your pain increases on changing altitude, and unable to pop the ears.
Ringing in the ears(Tinnitus).
Loss of hearing or sensation that sounds are muffled.
Feeling of fullness in the ears.
Vertigo( loss of balance).
Problems of behaviour.
Poor school performance due to hearing loss.
There are many conditions causing similar symptoms to ear fluid or at the same time may be present as fluid in the ear including :
Infection in Middle ear.
As ear fluid is often asymptomatic, mainly in children, most of the time it goes undiagnosed. If your child shows symptoms of fluid in the ear it is advisable to take him to a pediatrician or ENT specialist(ear, nose, throat). A specialist has better Diagnostic equipment, but their experience is necessary to recognise clues that show there is fluid in the ears.
Using Otoscope – For diagnosing fluid in the ear, the examination of the ear can be done by a method using an Otoscope or Otomicroscope. Your doctor will mostly use an Otoscope as they are more prevalent related to cost, an auto microscope allows more accurate diagnosis.
Using an otoscope is very simple for evaluating the ear, it involves pulling back the ear and inserting the tip of the otoscope into the ear. The doctor can see the eardrum. Experienced doctors actually see fluid level behind the eardrum, bubble or the eardrum is immobile.
Most of the time it is not so clear that the thing indicating fluid in the ear might be a slight retraction of the eardrum or some abnormal coloration. This is the reason a skilled physician is required to diagnose fluid in the ear.
Tympanometry Test– Another test to confirm fluid in the ear is tympanometry. This has similarity to an exam using an otoscope in the ear, in which the ear will be pulled back and the instrument’s tip called speculum is placed in the outer portion of the ear canal. The child has to hold very still during this test and prevent or avoid speaking or swallowing.
This instrument measures the pressure inside the ear and generates a tone. The tympanic membrane reflects a certain sound back into the tympanometry, which is charted on a graph known as tympanogram. The tympanic membrane stiffens if there is fluid in the ear and an abnormal sound will be reflected.
Treatment is not required for fluid in the ears. Within a few weeks the fluid usually drains on its own. If it does not then the treatment depends on several factors –
If fluid remains for 6 weeks, treatment includes a hearing test, round of antibiotics and further observations.
If fluid is there for 12 weeks, a hearing test is performed. If there is a lot of hearing loss, antibiotics are given or tubes are placed in the ears.
If the fluid is still there after 4 to 6 months, ear tubes placement surgery is necessary even if there is no hearing loss.
Adenoids are to be removed if they are large and causing blockage of the eustachian tube.
Fluid in the ears can be with or without an infection. Antibiotics are useless unless there is an ear infection and will not be used. Antihistamines are useful to prevent chronic sinusitis that may impact drainage of the auditory tube. Antihistamines are not used for treatment of fluid in the ear.
High risk children, those suffering from delayed development may require treatment earlier. It is the best thing for children who do not require treatment, manage symptoms and wait for the fluid to clear up on its own. Among children who require surgical intervention, full recovery is always achieved.
Avoid smoking of cigarettes.
Avoid allergens which are known.
If your child goes to a daycare, take him out or switch to a smaller daycare if he is getting fluid in his ears frequently.
Wash your hands and child’s toys regularly.
Do not overuse antibiotics.
Breastfeeding should be encouraged, even for just few weeks. Infants who breastfeed get less sick and are getting less ear infections even after many years.
Be regular on vaccines. The pneumococcal vaccine(Pregnant) prevents the common type of infections and the flu vaccine also helps as well.
Opposite to the popular belief, getting water in Young Child’s ears, will not cause serious otitis media. Children who frequently swim and not dry their ears may get swimmer’s ear, but it is a different condition completely.
To have fluid in your ear is a common problem, especially for children in their early years. Whether you are a child or an adult, the fluid in the ear will resolve without treatment.
If your symptoms continue for more than 6 weeks you should see your doctor. Untreated fluid in the ear for long can impact your quality of life and your performance at work or at school.
Hearing loss for a long time may be overcome by using a machine known as Hearing Aid which is easily available in the market for people who are suffering from hearing impairment.