Ear effusion is one of the main symptoms of acute otitis media. Acute otitis media is caused by infection. Fluid (mostly pus) accumulates in the inner ear, causing pain and redness of the eardrum, and may also cause fever. There may still be fluid in the ear after the infection has resolved, a condition called secretory otitis media. Ear infections and ear fluid are more common in young children. Ear fluid usually drains on its own, and there are some home remedies that can help with this process. However, the most important thing is to treat the underlying cause.

Diagnose the Problem

Watch for obvious symptoms related to your ears. The most common symptoms of acute otitis media and secretory otitis media include ear pain, fever, and vomiting. Children who do not know how to express pain may pull at their ears, become irritable, and cry. In addition, children may not eat or sleep well because lying down, chewing, and sucking can cause ear pressure changes that can lead to pain.

• Ear infections and ear fluid are most common in children between 3 months and 2 years old, and a parent or primary caregiver must explain detailed symptoms and medical history to the doctor on the child’s behalf. So, be sure to carefully record any symptoms you notice.
• Note that secretory otitis media is often asymptomatic. Some people may feel fullness in their ears and hear a “popping” sound when swallowing or yawning.
• If you notice any fluid, pus, or blood coming out, see your doctor right away.

Keep track of cold-related symptoms. Ear infections are considered secondary infections that occur along with a cold (the primary infection). Expect to experience common cold symptoms over the next few days, such as runny nose, congestion, cough, sore throat, and low-grade fever.

• Most colds are caused by viral infections. There is no cure for viral infections, so you usually don’t need to see a doctor. Only when the fever cannot be controlled by taking a moderate amount of paracetamol or ibuprofen and the body temperature exceeds 38.9°C, medical treatment is required. Keep a record of all cold symptoms so your doctor can learn about the underlying infection. A cold should last a week, but if it doesn’t get better after a week, see your doctor.

Watch for signs of hearing problems. Acute otitis media and secretory otitis media can block the transmission of sound and cause hearing problems. Signs of hearing loss include:

• No response to soft sounds or other noises.
• Always turn up the volume on your TV or radio.
• Talking very loudly.
• Lack of concentration.

Learn about possible complications. Most ear infections clear up on their own within 2-3 days and do not cause long-term complications. However, repeated ear infections, or fluid buildup even after the infection has healed, can cause serious complications, including:

• Hearing loss — Ear infections can cause mild hearing difficulty, but long-term infection or fluid buildup can cause more severe hearing loss, sometimes even damaging the eardrum and middle ear.
• Delayed speech development — Hearing loss in young children can cause delays in speech development, especially in young children who are not yet able to speak.
• Spread of infection — An infection that is untreated or does not improve with treatment may spread to other tissues and must be addressed immediately. When otitis media spreads to the protruding bone behind the ear, mastoiditis may occur, destroying the bone and forming an abscess. In some rare cases, severe otitis media may even spread to the skull, affecting the brain.
• Rupture of the eardrum — Infection can sometimes cause the eardrum to rupture or perforate. A ruptured eardrum will usually heal on its own in about 3 days, but in some rare cases, surgery may be needed to repair it.

If you suspect that you or your child has an ear infection or secretory otitis media, be sure to see a doctor for a diagnosis. The doctor will use an otoscope, which looks a bit like a flashlight, to examine the ear to see the condition of the eardrum. Often just an otoscope is needed to confirm the diagnosis.

• Your doctor will ask about the circumstances and nature of your symptoms, and you need to be prepared to answer these questions. If the child is sick, you need to answer for him.
• If the problem persists, occurs frequently, or does not improve with treatment, your doctor may refer you to an ear, nose, and throat specialist.

Drain Fluid from the Ear

Use a steroid nasal spray. They help open the Eustachian tubes and are available with a doctor’s prescription. Steroid nasal sprays reduce nasal inflammation and clear the Eustachian tubes. However, they take several days to fully take effect, meaning they do not relieve symptoms immediately.

Use over-the-counter decongestants to unclog your ears and drain the fluid. Decongestants come in the form of nasal sprays or oral pills and can be purchased at most pharmacies. Be sure to follow the directions on the label.

• Nasal decongestant spray should not be used for more than 3 days at a time. Long-term use can cause rebound swelling in the nasal cavity.
• Oral decongestants rarely cause rebound swelling, but some people experience heart palpitations or increased blood pressure after taking them.
• Children may experience other side effects, such as hyperactivity, restlessness, and insomnia.
• Avoid nasal sprays that contain zinc. In rare cases, they can cause patients to permanently lose their sense of smell.
• Always ask your doctor before using any nasal or oral decongestants.

Some people find antihistamines helpful, especially with lingering sinus infections, because they can relieve nasal congestion.

• However, antihistamines can cause serious side effects in the sinuses, including drying of the nasal lining and thickening of secretions.
• Antihistamines are not recommended for treating uncomplicated sinusitis or ear infections.
• Other side effects include dizziness, confusion, and blurred vision, and some children may become moody and have sensory overload.

Steam therapy at home can help open the Eustachian tube and drain the fluid. Basically, all you need is a warm towel and a bowl of hot water.

• Fill a large bowl of boiling water. You can add anti-inflammatory herbs such as chamomile or tea tree oil. Cover your head with a towel and point your ears toward the steam. Try not to stretch your neck, and only steam under the towel for 10-15 minutes.
• You can also take a bath with very hot water to see if the steam can dilute and drain the ear fluid. Don’t use this method on children, as they don’t tolerate extreme temperature changes as well as adults.

This method is highly controversial and has no scientific basis, but some people claim it is useful. Basically, turn the hair dryer to the lowest setting and blow the nozzle towards your ears from a distance of about 30 cm. It works on the principle that warm, dry air will heat the ear fluid into steam, thereby draining it out of the ear.

• Be careful not to burn your ears or side of your face. If you feel pain or overheating, stop using the hair dryer immediately.

During an ear infection, you can place a humidifier on a small table next to your bed in your bedroom and run it over the infected ear to unclog the ear and improve sinus health. Humidifiers promote steam production, unclog your sinuses, and help relieve fluid buildup in your ears. This method is especially suitable for use in winter because most houses have central heating systems installed and the indoor air is very dry.

• Placing a hot water bottle near the ear can have a similar effect and help drain fluid from the ear.
• If the patient is a child, a cool mist humidifier is recommended to reduce the risk of burns or injuries.

None of these methods are supported by reliable scientific data. Most studies show these methods have little effect. In most cases, fluid in the inner ear will clear up on its own unless it is the result of a chronic disease or ongoing ear infection.

• Most of the above methods can only deal with symptoms such as ear effusion and congestion, but cannot solve the underlying causes such as acute otitis media, secretory otitis media, and Eustachian tube obstruction.

Treat Ear Infections and Persistent Ear Fluid

No one best treatment works for everyone. Doctors consider many factors when deciding on treatment, including age, type of otitis media, severity and duration of the infection, how often ear infections occur, and whether they affect hearing.

Adopt a wait-and-see approach. Most of the time, given a little time, usually 2-3 days, the body’s immune system can fight and heal an ear infection. Because most ear infections resolve on their own, many doctors’ associations support a “wait and see” approach, which involves taking painkillers to relieve pain without antibiotics to treat the infection.

• According to the recommendations of the American Academy of Pediatrics and the Academy of Family Physicians, children between 6 months and 2 years of age who have pain in only “one” ear, and children over 2 years of age who have pain in “one or both” ears for less than 2 days, If the body temperature is below 39 degrees Celsius, you can adopt a wait-and-see attitude.
• Many doctors support this approach because antibiotics have their shortcomings, including their frequent misuse, which leads to the rapid proliferation of drug-resistant bacteria. Also, antibiotics cannot treat viral infections.

If the infection doesn’t clear up on its own, your doctor may prescribe a 10-day course of antibiotics to treat the infection and perhaps shorten the course of some symptoms. Commonly used antibiotics include amoxicillin, and if you are allergic to penicillin, azithromycin may be used instead. If you have frequent infections or if the infection is severe and painful, your doctor will prescribe antibiotics. In most cases, antibiotics can make any fluid buildup in the ear disappear.

• As for children 6 years old and above, if the doctor confirms from examination that they have a mild to moderate infection, they may prescribe a shorter course of antibiotics, about 5-7 days, instead of the 10 days required for adults.
• Be aware that benzocaine may cause a decrease in the amount of oxygen carried in the blood, especially in children younger than 2 years old. This condition is rare but fatal. Do not give benzocaine to children, and adults should only take recommended doses. Talk to your doctor about potential risks.

Be sure to take all antibiotics. Even if your symptoms subside halfway through the course of treatment, it is important to complete the entire course of treatment. If your doctor prescribes 10 days of antibiotics, be sure to take them as directed for 10 days. However, symptoms should improve within 48 hours. If you continue to have a high fever and your body temperature exceeds 37.8 degrees Celsius, it means that you may be resistant to the antibiotics and may need to change your dressing.

• Fluid may remain in the ear for several months after a course of antibiotics has ended. After taking antibiotics, you should see your doctor again to check whether the infection has resolved and whether there is still fluid in the ear. A follow-up visit is usually required about one week after the course of antibiotics.

Myringotomy was performed. If the ear effusion does not subside for a long time, for example, it persists for more than 3 months after the infection is cured or there is no infection; secretory otitis media recurs, 3 times in 6 months, or 4 times in 1 year, and in the past 6 months It occurs at least once a month; or if your ears are frequently infected and cannot be completely cured even after antibiotics are used, then you may choose to have ear surgery. A myringotomy drains the fluid from the middle ear and inserts a ventilation tube. It is usually an ear, nose, and throat specialist who decides whether you are a candidate for this surgery.

• In this outpatient procedure, an ear, nose, and throat specialist makes a small incision and places a ventilation tube into the eardrum. This helps to unclog the ear canal, prevent more fluid from accumulating, and allow existing fluid to drain completely from the middle ear.
• Some ventilation tubes are left in place for 6 months to 2 years, and then fall off on their own. Some remain in place longer and may require surgery to remove them.
• After the ventilator tube is detached or removed, the eardrum usually heals on its own.

In this surgery, the adenoids are removed at the back of the nose, just above the throat. Sometimes if you have recurring or persistent ear problems, your doctor may choose to perform this surgery. The Eustachian tube connects the ear to the back of the throat, where the opening at this end is near the adenoids. A cold or sore throat can cause the adenoids to become inflamed or swollen, which can press on the opening of the Eustachian tube. In addition, bacteria attached to the adenoids can sometimes be transmitted to the Eustachian tube, causing infection. In these cases, the Eustachian tube can become blocked and develop other problems, causing ear infections and fluid accumulation.

• Some children are born with larger adenoids and are more likely to cause problems, so this surgery is often used on them. The patient is injected with anesthetic, and then an otolaryngologist removes the adenoids through the mouth. Some hospitals classify it as a day surgery, which means the patient can go home the same day. Some surgeons require patients to stay in the hospital for one night for observation.

Pain Relief

Apply a warm, moist washcloth to the affected ear to relieve pain and throbbing. You can use anything to create a warm compress, such as soaking a washcloth in warm water, wringing it out, and applying it to your ear for immediate relief. Make sure the water is not too hot, especially if you are giving a warm compress to a child.

Your doctor may recommend over-the-counter pain relievers to relieve pain and discomfort, such as acetaminophen (Tylenol), or ibuprofen (Motrin IB, Advil). Be sure to follow the dosage instructions on the label.

• Aspirin should be used with caution in children or adolescents. Technically, aspirin can be used in children over 2 years old. However, recent studies have found that using aspirin to treat illnesses caused by viruses such as influenza and chickenpox may cause Reye’s syndrome. This rare condition can cause severe damage to the liver and brain in teenagers who are recovering from these diseases. Therefore, you must be careful when giving medication to teenagers. If you have any concerns, you can consult your doctor.

If the eardrum is intact and has not been ruptured or perforated, your doctor may prescribe ear drops to relieve pain, such as Aurodex Ear Drops, which combine antipyrine, benzocaine, and glycerin.

• If you are giving medicine to a child, first put the bottle containing ear drops into warm water to warm it up, otherwise the low temperature may irritate the ears. Have the child lie on a flat surface with the infected ear facing you. Use ear drops according to the directions on the label. Follow the recommended dosage and don’t drop too much. Follow the same steps when giving medication to an adult or to yourself.

Tips

• Sometimes secretory otitis media can occur without an ear infection. This may be a problem with the Eustachian tube itself.
• Do not try to remove ear fluid with a cotton swab. This pushes the fluid deeper into the ear canal and damages the eardrum.