This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Assessment of a child with otitis media with effusion

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Assessment of a child with OME should include:

  • a detailed history with focus on:
    • development of age appropriate speech and language

    • difficulties faced due to hearing loss such as
      • lack of concentration or behavioural problems
      • hearing fluctuation
      • poor educational progress
    • recurrent ear infection and upper respiratory tract infections (1,2)
      • in more than 50% of cases acute otitis media (AOM) precedes OME (although OME may occur and persist without an infection) (3)

    • balance problems and clumsiness

    • previous relevant medical history e.g. Down syndrome, cleft palate

    • social history - parental smoking

    • pregnancy, delivery and neonatal period - uncommon causes of sensorineural hearing loss, both hereditary and acquired should be considered (1,2)

  • clinical examination

    • examine the ear with an otoscope
      • there are no signs of an acute inflammation (4)
      • evidence of middle ear effusion include:
        • abnormal colour of the tympanic membrane e.g. - yellow, amber, or blue
        • loss of light refelx
        • opacification of the membrane (except due to scarring)
        • reduced or absent mobility of the tympanic membrane (can only be demonstrated with a pneumatic-otoscopy)
        • retracted/concave tympanic membrane or fullness or bulging (not typically)
        • presence of air bubbles or an air/fluid level (4)

    • general upper respiratory health

    • general developmental status(1)

  • hearing tests
  • audiometry, both impedance tympanometry and pure tone testing, is an essential part of the management of glue ear


  • co-existing causes of hearing loss should also be considered in children with OME e.g. - sensorineural, permanent conductive and non-organic causes (1)


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.