This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Otitis media (secretory)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

A unilateral serous effusion in an adult is due to nasopharyngeal tumour until proven otherwise.

‘Secretory otitis media’, ‘otitis media with effusion (OME)’, or `glue ear', is the accumulation of serous or mucoid fluid (but not mucopurulent fluid) in the middle ear cavity without signs and symptoms of an acute infection (1,2)

  • it often results in conductive hearing loss and is the most frequent cause of hearing problems in children
  • hearing loss which is usually mild and fluctuating in severity can in some cases lead to impairments of speech, language, and cognitive development, but the magnitude of these effects is not clearly established (2,3)
  • it is particularly prevalent in children with cleft palate and in those with Down's syndrome (3)
    • it affects 92–97% of children with cleft palate in their first year, and persists in 70% at age 4 (4)

Over 50% of effusions resolve spontaneously within 3 months and 95% within one year (1), but bilateral hearing loss, persisting 12 months, occurs in 5% of cases.

NICE suggest that with respect to children (5):

Be aware that children with OME often present with any of the following features:

  • hearing difficulties (for example, mishearing when not looking at who is speaking, difficulty in a group, asking for things to be repeated)
  • delayed speech and language development
  • ear discomfort tinnitus

Note also that the following can also be associated with OME:

  • behavioural problems (particularly lack of concentration or attention), being withdrawn, or irritability or
  • poor educational progress or
  • balance difficulties (for example, clumsiness)

Clinicians should have a higher suspicion of OME if the child has any of the following features, but be aware the absence of these features does not rule out OME:

  • a history of:
    • upper respiratory tract infections (URTIs)
    • acute otitis media (AOM)
  • craniofacial anomalies, for example Down syndrome and cleft palate
  • asthma
  • wheezing
  • dyspnoea
  • eczema
  • paroxysmal sneezing/nasal itching
  • urticaria
  • potentially harmful sucking habits (for example finger or dummy sucking and bottle feeding,) and mouth breathing
  • conjunctivitis

Note also that that OME is less likely in the absence of the following:

  • nasal obstruction
  • rhinorrhoea
  • current, or history of, adenoid hypertrophy


Related pages

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.


Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.