Otitis media with effusion – What are the signs and symptoms, relevant dDx., sequelae, work up, and treatment options?

Otitis media with effusion is the presence of fluid in the middle ear without signs or symptoms of ear infection, and typically follows acute otitis media.

Sn. & Sx.:

• Otalgia
• Aural fullness
• Hearing loss
• Tinnitus

dDx.:

• Cerumen impaction
• Cholesteatoma
• Foreign body
• Otitis (AOE, effusion)
• Tympanic membrane perforation
• Otosclerosis
• Tympanosclerosis
• Mastoiditis

Sequelae:

• Ossicular necrosis and/or fixation
• Cholesteatoma
• Mastoiditis
• Hearing loss, speech delay and learning problems in young children

Work up:

• Otoscopic exam (discoloration of the tympanic membrane, meniscus fluid behind the tympanic membrane, retraction pockets)

Tx.:

• Ear drainage
• Homeopathics: Belladonna, Chamomilla, Pulsatilla, Tuberculinum

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This post was written by Omar Rifai