Fluid accumulation in the middle ear is a highly common condition among the children who experience frequent upper airway infections, suffer from stuffy nose, or sleep with her/his mouth open and maybe snoring. Middle ear space is filled with air normally. Air pressure in the middle ear is equalized with the atmospheric pressure by the help of Eustachian tube which serves as a ventilation duct between the ear and the pharynx. Sudden pressure changes we feel during flights or diving are caused by a pressure imbalance between outer environment and middle ear when this mechanism could not react fast enough. Feeling a blockage in our hearing during flu infections is caused by the same reason. Eustachian tube opens when we swallow or wide open our jaw, and consequently air pressure gets equalized.

Fluid accumulation in the middle ear, or serious otitis media in medical terms, is highly common in pre-school children. Short distance between ear and pharynx in children, anatomically enlarged adenoids, frequent infections, and being prone to allergies are amongst the causes of frequent occurrence of this disease in infants.

A minor hearing loss starts in early stages of the disease. Common complaints include stuffy nose, sleeping with the mouth open, watching TV too loud or too close, difficulty in hearing teachers, and continuous nose discharge. Parents may not always be able to notice these complaints. Hearing loss is mostly noticed by school teachers.

Fluid accumulation in the middle ear could be corrected with a treatment targeted to cause, when diagnosed in early stages. Medical therapies for 15-20 days may usually resolve the problem. However, in the cases when medical treatment is ineffective such as enlargement of adenoids and tonsils causing obstruction in Eustachian tube, surgical intervention is warranted and provides highly satisfactory results. In the incurable, delayed cases permanent hearing loss may occur due to collapsed ear drum caused by negative pressure as a result of frequent middle ear infections.

Symptoms such as ear ache, fever and discharge are absent in cases of fluid accumulation in the middle ear. Occasionally, problems in relations with friends, performance drop in school, restlessness and balance disorders could be observed as primary complaints. All these issues occur due to hearing deficiency, and pressure imbalance between middle ear and outer environment.

Thus parents should bring their children to an ENT specialist when a hearing deficiency is suspected. If a disorder is detected, ENT specialist will investigate the causes for which a treatment will be targeted. Since nasal discharge and enlarged adenoids due to allergies are common in such children, evaluations and tests for allergic status should be considered.

Surgeries for implanting ventilation tubes in to ear drum to resolve fluid accumulation in the middle ear are common interventions and they correct the hearing. These tubes usually drop by them selves after a period about 6 months.

To avoid a future hearing loss and to save our children being inferior to their peers during their educational ages, we should be aware of hearing loss and admit to a physician without delay.