Serous Otitis Media

The middle ear is the small pocket of space behind the eardrum, which has a series of small bones called ossicles. Usually this pocket contains air, and the ossicles transmit vibrations from the eardrum to the inner ear. This is how we experience hearing.

The air in the middle ear enters from the back of the throat through the eustachian tubes.

Sometimes, however, the eustachian tube on one or both sides doesn’t work properly. This prevents air from getting into the middle ear causing it to be filled by fluid from the surrounding tissues. Although the ear is not yet infected at this stage, this situation can lead to infection.

When fluid is present in the middle ear, the eardrum and ossicles can’t transmit sound clearly to the inner ear and hearing is decreased. This condition is called serous otitis media. It may exist with or without an upper respiratory infection such as a cold. Serous otitis media can occur at

any age, but it is especially common in children, and can remain after an ear infection is otherwise successfully treated or after a cold has cleared up.

Although preventing this condition is difficult and sometimes impossible, anything that can reduce the chance of catching a cold is valuable. Prop up your infant in a semi-sitting position when he or she is taking a bottle. During colds, blow the nose gently. And always avoid exposure to cigarette smoke.

The symptoms of serous otitis media—temporary hearing loss, popping sounds in the ear, or a feeling of fullness in the ear—frequently go away on their own within ten days. In some children (and less commonly in adults), however, the fluid stubbornly remains week after week. If you think your child has serous otitis media, call your child’s health care professional. If there is no improvement after monitoring the condition for a period of perhaps three or four months, your health care professional will probably want to consult with an ear specialist.

Surgery may be advised if the specialist believes that the middle ear fluid is not likely to disappear soon. Typically, a small incision is made in the eardrum and the fluid is drained. A small plastic tube is then inserted through the incision and is left in place. This tube provides a small ventilation hole in the eardrum and temporarily takes the place of the eustachian tube.

Hearing usually improves immediately after the tube is inserted. And since fluid is no longer

accumulating in the middle ear, new ear infections are less likely. The tube usually remains in place from six to 12 months, and then falls into the external ear canal where it can be removed.

In some cases it falls out by itself. By the time the temporary tube falls out, the eustachian tube usually will have improved.

In some cases, the adenoids (the lymphatic tissue high in the back of the throat) can interfere with the function of the eustachian tubes. Your ear doctor may decide that removal of this tissue is in your child’s best interest. This procedure is called an adenoidectomy.