From the Guidelines
Otitis media with effusion (OME) most commonly affects children between 6 months and 3 years of age, with a peak incidence around 2 years of age. This condition, characterized by fluid accumulation in the middle ear without signs of acute infection, is highly prevalent in young children due to their anatomical and immunological characteristics, as noted in the study by 1. The shorter, more horizontal Eustachian tubes in young children impair proper drainage and ventilation of the middle ear, making them more susceptible to OME. Additionally, children in this age group often have enlarged adenoids and are frequently exposed to respiratory infections in daycare settings, both of which contribute to Eustachian tube dysfunction, as discussed in the study by 1. The immature immune system of young children also plays a role, as they are still developing immunity to common respiratory pathogens. Some key points to consider when evaluating OME in children include:
- The high prevalence of OME in children, with over 50% of children experiencing OME in the first year of life and over 60% by age 2 years, as reported in the study by 1
- The potential for OME to cause hearing loss, balance problems, and other complications, as noted in the study by 1
- The importance of proper diagnosis and management of OME, including watchful waiting and the use of tympanostomy tubes in certain cases, as discussed in the study by 1 While OME can occur at any age, including in adults, the anatomical and immunological factors make young children significantly more vulnerable, with approximately 90% of children experiencing at least one episode before school age, as mentioned in the study by 1.
From the Research
Age Group Affected by Otitis Media with Effusion
- The age group most affected by otitis media with effusion (OME) is children, with up to 80% of children affected by the age of 4 years 2, 3.
- The prevalence of OME declines beyond 6 years of age 2, 3.
- OME can occur in children or adults after upper respiratory tract infection or acute otitis media, but it is more common in children 2, 3.
Characteristics of OME in Children
- Half or more of OME cases resolve within 3 months and 95% within 1 year 2, 3.
- Complications such as tympanic membrane perforation, tympanosclerosis, otorrhoea, and cholesteatoma can occur 2, 3.
- OME has been associated with delayed language development, particularly if the disease is recurrent or of long duration 4.
- Children with a history of OME may have significant lower scores in articulation tests and sound discrimination tests 4.
Treatment and Outcomes of OME
- There is no evidence of benefit from steroid treatment (oral or topical) in terms of hearing loss associated with OME 5.
- Oral steroids, especially when used in combination with an oral antibiotic, may lead to a quicker resolution of OME in the short term, but there is no evidence of longer-term benefit 5.
- The hearing loss related to OME averages 18-35 dB HL, with impaired speech-in-quiet and speech-in-noise perception 6.