Otitis media with effusion (OME), also called serous otitis media, is defined as middle-ear effusion without acute signs of infection . The term “glue ear” is sometimes used as a synonym for OME, but should be reserved for cases in which the effusion is long-standing and the fluid in the middle ear has become thick and glue-like . OME often occurs after acute otitis media (AOM), but it also may occur with eustachian tube obstruction in the absence of AOM. Some children, specifically as described in indigenous populations, may have relatively few symptoms despite the presence of an opaque and bulging tympanic membrane. These children usually have a purulent otitis despite the absence of systemic signs such as fever .
The clinical features and diagnosis of OME will be reviewed here. The management of OME and the clinical features, diagnosis, treatment, and prevention of AOM are discussed separately:
Otitis media with effusion (OME) often occurs after an episode of acute otitis media (AOM). In such cases, the middle ear effusion may persist for weeks to months after the acute symptoms have resolved [4,5]. However, some children develop chronic OME, defined as OME that persists for three months or longer. The epidemiology of AOM is discussed separately. (See "Acute otitis media in children: Epidemiology, microbiology, clinical manifestations, and complications", section on 'Epidemiology'.)
OME also is common among apparently asymptomatic young children [6,7]. In three birth cohorts of children who were serially examined with tympanometry and/or otoscopy, 90 percent of children (80 percent of ears) had at least one episode of OME by four years of age . The prevalence ranged from 10 to 17 percent among children through four years of age, and then decreased to 3 to 4 percent between six and eight years. Similar rates have been noted in other cohorts [7,8]. OME is more common in the winter than in the summer .