Otitis Media with Effusion

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Treatment

In otherwise healthy children, the first line treatment for OME is to adjust environmental factors if possible (encourage breast-feeding, avoid cigarette smoke, reconsider group day care). If allergies are present, avoiding the allergens can be effective (e.g., house dust). Most often the fluid will clear on its own, and suggested treatment might be either to wait and observe, or to try a single round of antibiotics.

If the fluid is still present after 6 weeks, treatment might include further observation, a hearing test, and/or a single trial of antibiotics (if not given earlier).

If the fluid is still present at 12 weeks, hearing should be tested. If there is significant hearing loss (> 20 decibels), antibiotics or ear tube placement (grommets) might be appropriate.

If the fluid is still present after 4 to 6 months, tubes are probably indicated even if there is no significant hearing loss. Laser myringotomy is a newer alternative to ear tube surgery.

Sometimes adenoid removal is necessary to restore proper functioning of the Eustachian tube.

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