Fluid in the ears commonly affects children from infancy until about ten years of age.  The medical term for this problem is Otitis Media with effusion, also known as Serous Otitis Media.  Many schools screen children for this problem.  It is not uncommon for the school nurse to see the need to send a note home indicating that a child has failed a hearing test.  Most often the note will include a suggestion that the child be checked by an ear doctor. Children with Down ’s syndrome and cleft palate very often have problems with fluid in the ears.

The ear has a space behind the ear drum called the middle ear. The lining of this space makes a fluid to keep the tissues moist. This fluid drains through a little tube (eustachian tube) that runs to the back of the nose.  Colds, allergies, infected adenoids, or sinusitis, can cause congestion of the nose and eustachian tube.  This congestion causes the tube to be blocked.  With the tube blocked the fluid in the middle ear cannot drain.

The fluid causes two problems.  First, the sound waves are not transmitted through the ear and this causes a hearing loss.  This can be a very serious problem with children trying to hear a teacher in a noisy classroom. Most children will become bored very quickly if they can't hear what's going on and an educational delay can occur.  Although this is serious, it is not quite as dangerous to the health of the child as the second problem.

The second problem is that the bacteria and viruses just “love” that fluid and will grow very rapidly if the child gets an infected throat or nose. Once started, an ear infection can become severe in a matter of hours.

Fluid in the ear is treated in two ways.  The first treatment involves trying to decrease the congestion in the back of the nose.  Usually a decongestant/antihistamine combination is given.  An antibiotic is also frequently given with the decongestant.  The fluid will go away with these medications in a period of six to twelve weeks.

If the fluid doesn't clear, the second treatment is then used.  A small Teflon tube is surgically placed through a hole made in the ear drum.  In children this means having a general anesthesia. The tubes (middle ear ventilation tube) work very well, allowing the fluid to drain out and the air to flow in.   However, there is one problem that can arise with ear tubes.  That problem occurs if water is allowed to get into the ear.  If water gets into the ear, it may flow through the tube and start an infection in the middle ear.  Children with tubes should not go swimming and must be very careful when they bathe.

Tube placement in the ears is one of the most common operations done in the United States, today.  Through the use of tubes, ear doctors have almost eliminated the serious ear disease that develops with long standing Serous Otitis Media.