Fluid accumulation in the middle ear is a common disease. It occurs most often in the preschool period. More than half of children experience middle ear effusion in their first year of life. Otitis with effusion is a disease that occurs with the accumulation of fluid in the middle ear without pain and fever. The most important symptom is hearing loss. The child’s loud television viewing, decreased response to sounds, or decreased school performance are the main symptoms of fluid in the ear.


The middle ear opens to the nasal cavity with the Eustachian tube, the task of the Eustachian tube is to provide ventilation of the middle ear. Since the Eustachian tube is shorter and horizontal in children than in adults, it is easier for microbes to progress to the middle ear. Another reason why otitis media is more common in children is the presence of adenoids. The adenoid both blocks the mouth of the Eustachian tube and acts as a source for microbes that cause middle ear infections. Insufficient development of the immune system in children and the presence of allergic rhinitis in some cases also cause fluid accumulation in the middle ear.


There may be dulling and increased vascularity in the eardrum, cambering in the membrane, air bubbles behind the eardrum, and sometimes collapse of the eardrum. On examination, enlarged adenoids and other causes that lead to fluid accumulation can be detected. Hearing test and middle ear pressure test confirm the diagnosis.


The treatment of fluid accumulation in the ear is primarily drug therapy. Antibiotic treatment is started for 10-14 days. In addition, auxiliary drugs are given for allergy treatment in allergic patients. If adenoid problems, hearing loss and collapse of the eardrum continue after the necessary treatment and follow-up, surgical treatment should be applied.

In the surgical treatment, the adenoid is removed, a scratch is made on the eardrum and the fluid accumulated in the middle ear is cleaned, a tube called a ventilation tube is applied on the eardrum, which provides ventilation of the middle ear.

The operation is performed under general anesthesia in children and local anesthesia in adult patients.

Tubes are expelled by the body after about 6-9 months. In repetitive tube applications, long-term tubes called t-tubes that cannot be easily thrown out on the body side can be used.

After the tube is inserted, the ear should be protected from water. Vaseline cotton or ear plugs can be used during the bath.