Managing middle ear fluid

You may be aware that middle ear infections and middle ear fluid are common in young children. Many pediatrician visits result in treatment for otitis media. In children this presents as “glue ear” and may be accompanied by pain, fever and reduced hearing. The middle ear is the air space behind the ear drum. Children are known to be more prone to this condition due to their more horizontal Eustachian tubes and tendency to harvest infections in general. Pain may increase until the eardrum ruptures from fluid pressure. Over 5 million cases of acute Otitis Media are reported annually in the US.

Adults can find themselves with middle ear fluid as well. Patients often report their primary physician suspects “fluid in the ears”. Often the fluid trapped behind adults’ eardrums is watery and painless. Infection may not be present. This may be the result of Eustachian tube dysfunction, in which the middle ear space cannot drain to the throat, due to congestion or blockage. The tympanic membrane (eardrum) is pulled backwards from negative pressure. Yellow watery fluid can be drawn from the tissues lining the middle ear cavity.

Symptoms most seen in adults include drainage, ear pain, decrease in hearing, ear fullness sensations, recent dizziness or balance difficulty, fever (if there is an infection).

Adult risk factors for middle ear fluid include GE reflux, smoking, allergies, upper respiratory infections, immune system suppression (as with diabetes, chemotherapy, and autoimmune disorders), sinus congestion, enlarged tonsils/adenoids, and family history.

If you suspect fluid in your ears, they should be examined promptly.  A visual inspection of the canals and eardrums, tympanograms and pure tone audiogram can verify or rule out fluid. A visit to an audiologist prior to a medical exam can aid the physician in the diagnosis. Medical or surgical management of the ear is typically performed by an otolaryngologist, or Ear, Nose and Throat physician. Sudden hearing decrease and ear fullness without middle ear fluid may indicate a sudden sensory hearing loss. This should be treated immediately.

Treatment options for fluid include antibiotics, analgesics, as well as supplements. Chronic Otitis Media may be treated by means of myringotomy and insertion of ventilation tubes through the tympanic membrane.

Do not wait if you or your physician suspect fluid in your middle ears. A thorough diagnostic ear exam from an audiologist is the first step toward appropriate treatment and relief. As always we wish to keep you on a clear path to good hearing and ear health.