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Fluid in the Ear (Secretory Otitis Media) in Children


The Manual's Editorial Staff

Last full review/revision Jul 2020| Content last modified Jul 2020
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Your middle ear is a hollow space behind your eardrum. The middle ear contains 3 tiny bones that transmit vibrations of your eardrum to the nerves in your inner ear.

Your eustachian tube connects the back of your throat to your middle ear.

Your ear canal is the tube that connects the outside of your ear to your eardrum.

Inside the Ear

Inside the Ear

What is secretory otitis media?

Fluid can build up in your middle ear, usually after a middle ear infection (otitis media). This is what doctors mean when they say you have fluid in your ear. They aren't talking about water that got in your ear canal from a shower or swimming. "Media" means middle, and "otitis" means inflamed ear, so when fluid is secreted into your middle ear, doctors call it secretory otitis media.

  • Although it can happen after an ear infection, the fluid in secretory otitis media isn't infected

  • Secretory otitis media can happen at any age but is most common in children

  • You may feel a fullness in your ear and have some hearing loss

  • Doctors look in your ear and use a sound wave test to tell if you have fluid in there

  • Doctors may need to make an opening in your eardrum to let fluid drain

What causes secretory otitis media?

Normally, you release pressure in your middle ear when you swallow. Swallowing causes your eustachian tubes to open, which can happen 3 to 4 times per minute. If an eustachian tube is blocked, fluid builds up in your middle ear so that your eardrum can't move the way it should.

Eustachian tube blockage can happen when colds or allergies cause the lining of the eustachian tube and adenoids to swell. Adenoids are clumps of tissue that help fight infection and are right near the opening of the eustachian tube.

What are the symptoms of secretory otitis media?

  • A feeling of fullness in your ear

  • A popping or crackling sound when you swallow

  • Some hearing loss

  • Sometimes, loss of balance

If young children have secretory otitis media with hearing loss for a long time, they can have trouble learning how to speak. Secretory otitis media also raises the risk of getting more ear infections (acute ear infections).

How can doctors tell if my child has secretory otitis media?

Doctors will:

  • Look at your child's ear with a handheld light

  • Do a sound wave test to check for fluid (called tympanometry)

  • Do a hearing test

How do doctors treat secretory otitis media?

Most people will get better without treatment. Antibiotics don't help secretory otitis media.

To briefly relieve the fullness in your ear, you can breathe out while you close your mouth and pinch your nose shut.

If your symptoms last more than 3 months, a doctor may need to:

  • Make an opening in your eardrum to let the fluid drain

  • Place a small tube in your eardrum to let air behind it and keep fluid from building up again

  • Do surgery to take out your adenoids

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