What is otitis media with effusion (OME) ?

Otitis with Effusion in is a condition characterized by the accumulation of fluid in the middle ear, behind the eardrum without pain and fever.

Who are prone to OME ? What are the symptoms ?

OME is mostly seen in children. The most important symptom is hearing loss. Since there are no other signs and symptoms such as pain and fever, it is necessary to be careful in order to make the diagnosis.

How does the effusion in the ear occur ?

Children are prone to middle ear infections. The Eustachian tube runs more horizontally in children than in adults and reaches its adult angle at the age of 7 years. Adenoid problems are also frequent during childhood. The adenoid can both cause obstruction at the level of the opening of the Eustachian tube, and also act as a reservoir for some microbes that play a role in middle ear infections. In addition to all these factors, the fact that the child's immunity is at the stage of maturation, and allergic rhinitis can also contribute to ear infection formation. Otitis media is most common in the first 3 years of life. In a child with acute otitis media, the effusion behind the eardrum persists in 40% of cases for 1 month, and in 10% of the cases for 3 months or longer.

How does effusion occur in adults ?

Effusion in the ear of adults usually occurs following a viral upper respiratory tract such as common cold. If only one ear is affected with and a painless growing mass in the neck on the same side, these findings might be suggestive of nasopharyngeal carcinoma.

How is the diagnosis made ?

In the examination, tympanic membrane color might change into amber or gray, air bubbles or an air-fluid level can be seen. Middle ear pressure test and hearing test confirm the diagnosis in a patient with suspected OME.

What is the treatment of OME ?

The treatment of OME in primarily medical therapy. Since the effusion in question has been shown to be inflammatory, the agreed treatment is antibiotic therapy. The patient is given a 10-14 days course of antibiotic therapy. In addition, decongestants, antihistamines for allergic patients, and cortisone sprays can be used in medical treatment. Then, the patient is followed up. If there are no additional conditions such as abnormal changes in the eardrum, or severe hearing loss, the patient can be followed up with intermittent controls for up to 3 months. If the effusion is not resolved at the end of this period, surgery is performed.

What surgery is done for OME ?

In surgical treatment, a ventilation tube is placed through the eardrum. In pediatric patients, an adenoidectomy is also performed.

Is the surgery performed under general anesthesia ?

General anesthesia is used in pediatric patients. In adult patients, the procedure can be performed with local anesthesia.

Is the tube visible from the outside ?

No, the tube is not visible from the outside.

How long does the tube last ?

This is related to the type of tube inserted. In a patient who undergoes ventilation tube insertion for the first time, short-term tubes are usually preferred. They last on average for 6-9 months. Generally, at the end of this period, the tube can be found on external ear canal on otoscopic examination. If the tube is in place for more than 1 year, it can be removed in operating theatre. In recurrent OMEs, long-term tubes called T-tubes can be used.

What should be considered after the tube insertion ?

Once the tube is inserted, the ear should be protected from water. One of the best ways to do this is vaseline cotton balls. If there is a discharge from the ear, a physician should be consulted immediately. The infection can usually be controlled with antibiotics and some anti-inflammatory drugs.