Fluid in Ear

Written by Dr. Mary

What is Fluid in Ear?

The condition of having fluid in the ear is called Serous Otitis Media or Otitis Media Effusion. It is defined as a result of impaired auditory tube or known as Eustachian tube. It is commonly found in children but can also affect adults which may indicate underlying cause for Eustachian tube dysfunction.


Serous otitis media is a condition in the middle ear characterized by a collection of ear fluid as a result of negative pressure in the middle ear cavity brought by an obstruction in the Eustachian tube and in the absence of infection. The fluid may cause hearing impairment when it impedes the vibration of eardrum by sound waves. The ear fluid may result to conductive hearing loss when the ear fluid becomes sticky and thick over time.

Eustachian tube connects the inner ear to the back of the throat and helps in draining fluid to prevent it from accumulating in the ear. The presence of obstruction in the Eustachian tube will cause fluid to build up in the ear. In children or infant, the most common cause for ear fluid is feeding while lying down which tends liquid to flow inside the ears and become trapped in the middle ear cavity. Children are most prone to fluid buildup owing to the short size of their Eustachian tube and it is more horizontal that may also be blocked by large adenoids.

Serous otitis media is frequently seen in patients after undergoing radiation therapy and patient with dysfunctional Eustachian tube associated with upper respiratory infection or barotraumas.

The condition of serous otitis media occurs without infection however, effusion and infection are related one way or another such as effusion remains in the middle ear cavity for a few days after treating ear infection. Ear infection may also occur while the Eustachian tube is partially blocked allowing bacterial growth as a result of fluid buildup containing bacteria.

Fluid in EarPicture : Showing normal and fluid filled ear (effusion)

Image source: hearingaid-specialist.org

Fluid in Ear Symptoms

Ear fluid buildup may manifest with or without symptoms. Most children suffer from serous otitis media without symptom as it usually occurs without pain or fever. If symptoms manifest, these are:

  1. Recurrent mild ear pain
  2. Feeling of fullness in the ear or sensation of congestion
  3. Hearing muffled sound or popping and crackling noise while the Eustachian tube appears to open
  4. Impaired hearing ability
  5. Children may have delayed development in speech and language including motor skills and balance
  6. Dizzy spells or vertigo

Fluid in Ear Diagnosis

Fluid in the ear is usually diagnosed during examination of the ear for another reason. Often a child’s ear or even an adult’s ear is examined for an infection in the ear and healthcare provider can only then recognize the occurrence of fluid in the ear.

Confirmation of fluid in the ear may be further diagnosed thru the following:

  1. Tympanometry – a more accurate tool for diagnosing serous otitis media and also measures the thickness of the fluid
  2. Acoustic otoscope – a portable device that accurately detects the presence of fluid in the ear

Tympanic membrane will manifest changes and can be seen during otoscopy and these changes are:

  1. Tympanic membrane is dull in appearance
  2. Air bubbles can be seen in the middle ear
  3. Eardrum is unmovable when blown or puffed with small amount of air
  4. Presence of fluid behind the eardrum

Fluid in Ear Treatment

Fluid in ear usually resolves on its own except when associated with infection. Children will overgrow it as they grow old as the Eustachian tube gradually increases in size as they age.

Serous otitis media or effusion in the ear that does not resolve on its own given an ample time and is associated with hearing impairment may require certain surgical procedure to drain the fluid and relieve pressure.

Myringotomy is a surgical procedure most commonly utilized for treating serous otitis media. The procedure requires a small incision in the tympanic membrane and insertion of an ear tube known as myringotomy tube, usually made of plastic or metal, to hold open the Eustachian tube allowing continuous drainage of fluid and pus and to ventilate the middle ear.

Antibiotics may be given if effusion is persistent for more than 8 to 12 weeks although antibiotics are not helpful in draining the fluid. The intention of antibiotic is to treat the infection that may cause the effusion.

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