Otitis Media with Effusion
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- Also called serous otitis media, secretory otitis media, nonsuppurative otitis media, “ear fluid,” or “glue ear”
- Otitis media with effusion (OME) is defined as the presence of fluid in the middle ear in the absence of acute signs or symptoms of infection.
- More commonly, a pediatric disease
- May occur spontaneously from poor eustachian tube function or as an inflammatory response after acute otitis media (AOM)
Approximately 90% of children have OME before school age, mostly between the ages of 6 months and 4 years.
- Approximately 2.2 million new cases annually in the United States
- Less prevalent in adults and is usually associated with an underlying disorder
Etiology and Pathophysiology
- Chronic inflammatory condition where an underlying stimulus causes an inflammatory reaction with increased mucin production creating a functional blockage of the eustachian tube and thick accumulation of mucin-rich middle ear effusion
- Young children are more prone to OME due to shorter and more horizontal eustachian tubes, which become more vertical around 7 years of age.
- Biofilms, anatomic variations, and AOM caused by viruses or bacteria have been implicated as stimuli causing OME. The common pathogens causing AOM include nontypeable Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis.
- In adults, OME is often associated with paranasal sinus disease (66%), smoking-induced nasopharyngeal lymphoid hyperplasia and adult onset adenoidal hypertrophy (19%), or head and neck tumors (4.8%).
OME is generally not preventable, although lowering smoke exposure, breastfeeding, and avoiding daycare centers at an early age may decrease the risk.