Middle ear inflammation (Secretory otitis media)

Author: Helan Hussein Mussa

KEMSA Medical Database Middle ear inflammation (Secretory otitis media)
KEMSA Medical Database Middle ear inflammation (Secretory otitis media)

If your child is between the ages of 2 and 4 and has problems listening to what you say or having problems with language development - this might be a sign of hearing loss due to prolonged fluid existing in the middle ear.¹

Most probably all children by the age of three years old have experienced at least one episode with middle ear fluid accumulation (effusion). Furthermore, children between 2-4 years old might have experienced bilateral hearing loss due to SOM persisting (more than 3 months) 2.



SOM can arise from a dysfunction in the auditory tube (eustachian tube) if there is:

  • Decreased ventilation in middle ear due to either inner lining (mucosal) of the tube swelling or other reason for it.
  • Irritation of the inner lining causing increased mucous secretion with fluid accumulating in the middle ear.

It can also be a primary or secondary cause:

  • Secondary after an acute otitis media or upper airway infection.
  • Primary is without any known cause.


Possible that there are no symptoms present, but hearing loss could be noticed. Patients may experience a feeling of fullness, pressure, or popping in the ear with swallowing3. Rarely there is pain involved.



Various possible changes to the eardrum (tympanic membrane) can be noticed by ear examination (otoscopy). For older children there is the possibility to do hearing test.                                     To confirm middle ear fluid accumulation, by a device called tympanometry which will show a flat curve if there is fluid present.


if there are not any apparent symptoms the patient can be observed for at least 3 months, because after this period of time spontaneous healing can occur (in 80 % of cases). If the symptoms such as speech problem and hearing loss doesn’t disappear after 3 months seek medical help.

Antibiotics has no place in treatment. Instead the fluid must be drained and the eustachian tube better ventilated.