Otitis Media with Effusion
Basics
Description
- 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)
Epidemiology
Approximately 90% of children have OME before school age, mostly between the ages of 6 months and 4 years.
Incidence
Approximately 2.2 million new cases annually in the United States
Prevalence
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%).
Risk Factors
General Prevention
OME is generally not preventable, although lowering smoke exposure, breastfeeding, and avoiding daycare centers at an early age may decrease the risk.
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Citation
Domino, Frank J., et al., editors. "Otitis Media With Effusion." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688846/all/Otitis_Media_with_Effusion.
Otitis Media with Effusion. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688846/all/Otitis_Media_with_Effusion. Accessed December 10, 2024.
Otitis Media with Effusion. (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688846/all/Otitis_Media_with_Effusion
Otitis Media With Effusion [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 December 10]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688846/all/Otitis_Media_with_Effusion.
* Article titles in AMA citation format should be in sentence-case
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