Definition

Otitis media with effusion (OME) is the persistence of fluid in the middle ear for a period of 3 months or more. It is also referred to as ‘glue ear’.

Incidence and Aetiology

OME is the most common cause of hearing loss in children. Persistent fluid in the middle ear is common following an episode of acute otitis media (AOM). Most parents will notice that children may be slightly deaf for several weeks after an ear infection. Fluid persisting for more than 3 months is pathological and is termed OME.

The prevalence of OME is highest in children from the age of about 2 to 7 years. Up to 30% of children in this age group at any one time may be affected. OME is more prevalent in winter than summer months. It may be caused by infection, but pressure changes in the middle ear associated with Eustachian tube dysfunction are also implicated. The adenoids can have an important role, either because of infection spreading from the adenoids into the ear via the Eustachian tube or because they contribute to Eustachian tube obstruction and pressure changes in the middle ear. Another theory is that the adenoids become coated with a matrix (biofilm) that is resistant to the immune defences and to antibiotics and contributes to recurrent infections in the ear mucosa. Children with Down syndrome and cleft palate are especially susceptible to OME.

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