Fluid collection behind the eardrum (also called otitis media with effusion) is common, especially in children under two. In most cases, this occurs following an ear infection, allergy, or cold, where inflammation blocks the Eustachian tube —A narrow canal responsible for fluid drainage from the ear. (1)

These fluids are usually gradually drained from the ear. However, in other instances, the blockage can persist for months, and as more fluid collects in the space behind the eardrum, symptoms such as reduced hearing will appear. (1)

Symptoms of Fluid Behind the Eardrum

The most common symptom of fluid collection behind the eardrum is hearing loss, either in one or both ears. In adults, it may be a feeling of blockage in the ear or reduced hearing.

In children, you may notice behaviors like turning up the TV volume, frequently asking for questions to be repeated, or speaking loudly. Younger children may also experience delays in speech and language development, and mispronounce words. These behaviors often stem from temporary hearing loss, interfering with learning sounds and words. (2)

Other symptoms, in addition to hearing loss, may include the following: (2)(3)

• Tinnitus (ringing in the ear).
• A feeling of pressure or fullness in the ear.
• Popping sound in the ear during swallowing.
• Ear pain.
• Dizziness and balance problems (if the inner ear is affected).
• Ear drainage, which may contain blood, pus, and/or earwax (this indicates severe infection).

If you or your child has these signs, make an appointment right away with the ENT department in Dr. Soliman Fakeeh Hospital, and receive comprehensive support throughout the process, from diagnosis to recovery.

How Common Is This?

Almost 75% of children will experience fluid in the ear by the time they reach the age of three. (3)

There are additional factors that increase the risk of having fluid behind the eardrum, including: (3)

• Upper respiratory tract infections, such as colds and sinusitis.
• Allergies.
• Tobacco smoke or living with a smoker.
• Overcrowded daycare.
• Enlarged tonsils or adenoids.
• Conditions that compromise the immune system, like diabetes or chemotherapy.
• Acid reflux.

Is Fluid Behind the Eardrum Serious?

No, in most cases the fluid will clear on its own within 2 to 3 months or sooner. Children will not typically have any lasting damage to their hearing or speech, even if the fluid is left in the ear for a long time. (1)

But in rare cases of continued accumulation of the fluid behind the eardrum for over three months, some complications may arise, including: (1)

• Persistent hearing loss.
• Recurrent ear infections.
• Speech and language delays in children, which can impact their academic performance.

When Should You See a Doctor?

Visit your doctor if you notice fluid or discharge from the ear. While waiting, keep your ear dry and avoid swimming and bathing. (4)

You should contact your doctor immediately in these cases: (4)

• Redness, swelling, and severe pain in the ear.
• Fever.
• Dizziness and balance problems.
• Ear symptoms that were caused by a head injury.

How Is Fluid Behind the Eardrum Treated?

In mild cases, the fluid will disappear in about 2-3 months. During this period, your doctor will closely monitor the condition. Regular monitoring is essential to track the progression of the condition and see if it is improving or deteriorating. (1)

If the fluid has not cleared after three months, ear tubes may be inserted to drain the fluid. These tubes are typically left in place for several months to ensure ongoing drainage. (1)

References

1. Familydoctor - Otitis Media (with Effusion)
2. Cleveland Clinic - Glue Ear
3. Clear Choice Hearing and Balance - Middle Ear Fluid
4. Healthdirect - Fluid from the ear