Otitis Media with Effusion

Question 1

What is it?

Answer 1

Accumulation of fluid within the middle ear

Question 2

What are risk factors?

Answer 2

Male
Siblings with history
Cleft palate
Down Syndrome
Allergic rhinitis
Bottle feeding
Day care attendance
Parental smoking

Question 3

What are clinical features?

Answer 3

Peake at 2 years of age
Hearing loss= most common symptom
May present as speech/language delay, poor concentration/progress at school
Watching TV at high volume

Question 4

What is found on otoscopy?

Answer 4

TM discolouration e.g. yellowing
Air/fluid level or bubbles behind the TM
Retracted TM
Blunting of light reflex

Question 5

What investigations are required?

Answer 5

Pneumatic otoscopy
Tympanometry
Audiometry should be performed

Question 6

What is the management?

Answer 6

1) Active observation for 3 months
- spontaneous resolution is common so observation is appropriate for most children
- patients with down’s syndrome or cleft palate should be referred to ENT

2) Grommet Insertion to allow air to pass normally stop working after 10 months