Middle Ear Effusion in Children: Causes, Treatment, and Concerns

Q: Middle Ear Effusion in Children: Causes, Treatment, and Concerns

Hello： (1) If you have had a cold for two months, I recommend getting a chest X-ray to check for pneumonia or other issues. <br>There is also a possibility of allergies, so a blood test to check for mycoplasma levels and allergy markers would be helpful to guide treatment. <br>(2

Middle ear effusion

Hello Dr.
Pei, I would like to ask you three questions...
(1) My daughter is five years old.
She caught a cold in early November last year, with symptoms of only a runny nose and cough.
We have visited the doctor several times, but she has not fully recovered.
Whenever the weather warms up, she shows slight improvement, but when a cold front arrives (there have been several recently), her symptoms worsen again.
This cycle has continued until now, and I am unsure what to do.
Is it possible to avoid taking Western medicine and use physical therapy, such as chest percussion, instead? (She has been intermittently taking Western medicine for nearly two months.) (2) However, on December 24 last year, she complained of pain in her right ear, so I took her to an otolaryngologist.
They said there was slight redness and swelling in the middle ear (otitis media) and that she must take medication for treatment.
After three days, we returned for a follow-up, and they noted fluid accumulation in both middle ears, prescribing more medication.
After another three days, they said the fluid had not resolved and advised continued medication.
This situation has persisted until now.
Yesterday, we went for another follow-up, and they said the fluid in the middle ear has decreased, but she still needs to continue the medication (during the period of fluid accumulation, my daughter reported hearing a faint buzzing sound in her ear).
I would like to ask the doctor, is it necessary to take medication to resolve fluid in the middle ear? Will the fluid not resolve on its own? How serious is the condition of fluid accumulation in the middle ear? (3) How long does the protection from the new influenza vaccine last? I apologize for the lengthy message, and I greatly appreciate your time in answering my questions.

Xiao Fen, 30~39 year old female. Ask Date: 2010/01/19

Dr. Pei Rensheng reply Pediatrics

Hello: (1) If you have had a cold for two months, I recommend getting a chest X-ray to check for pneumonia or other issues.
There is also a possibility of allergies, so a blood test to check for mycoplasma levels and allergy markers would be helpful to guide treatment.
(2) Otitis media is typically treated for 10 days.
Fluid in the middle ear is quite common, and 90% of patients will recover within three months, so there is no need for excessive concern.
If fluid persists after three months, surgical intervention should be considered.
If hearing tests show abnormalities, it is advisable to remove the fluid sooner to avoid hindering the child's learning and development.
(3) How long does the protection from the new influenza vaccine last? There is no standard answer, as it has just been developed! However, based on past vaccine experiences, it should provide protection for at least five years.
Since the circulating virus strains change each year, it is recommended to receive the seasonal vaccine annually for optimal protection! Wishing you health and happiness! Sincerely, Dr.
Pei Ren-Sheng, Head of Pediatrics, Taoyuan Hospital, Department of Health.

Reply Date: 2010/01/19

More Info

Middle ear effusion (MEE) in children is a common condition that can arise from various causes, including upper respiratory infections, allergies, and eustachian tube dysfunction. It is essential to understand the implications of MEE, its treatment options, and the concerns that may arise during its management.

1. Understanding the Condition: Your daughter's recurrent symptoms of nasal congestion and cough, especially with the changing weather, suggest that she may be experiencing ongoing upper respiratory issues that can lead to MEE. The eustachian tube, which connects the middle ear to the back of the throat, can become blocked due to inflammation or mucus, preventing normal drainage and leading to fluid accumulation in the middle ear. This condition can cause discomfort, pain, and even temporary hearing loss, as indicated by your daughter's experience of hearing a buzzing sound.

2. Treatment Options: In terms of treatment, while antibiotics are often prescribed to address bacterial infections, they may not always be necessary, especially if the effusion is not due to a bacterial infection. In many cases, MEE can resolve on its own without the need for medication. However, if your daughter is experiencing significant discomfort or if the effusion persists, medical intervention may be warranted.
Physical therapies, such as chest physiotherapy or techniques to help clear mucus, can be beneficial, particularly if your daughter is struggling with mucus clearance. However, it is crucial to consult with her healthcare provider before discontinuing any prescribed medications. They may recommend a watchful waiting approach, especially if the symptoms are mild and not affecting her daily activities.

3. Severity of Middle Ear Effusion: The severity of MEE can vary. In some cases, it may resolve spontaneously, while in others, it can lead to complications such as recurrent ear infections or hearing loss. If the fluid persists for an extended period (more than three months), it may be necessary to consider further interventions, such as tympanostomy tubes, which can help drain the fluid and equalize pressure in the ear.

4. Influenza Vaccine Efficacy: Regarding the influenza vaccine, its protective effects typically last for about six months, but this can vary based on the individual's immune response and the circulating strains of the virus. Annual vaccination is recommended to ensure optimal protection, especially in children, as their immune systems are still developing.

In conclusion, while MEE can be concerning, many cases resolve with time and appropriate management. It is essential to maintain open communication with your healthcare provider to monitor your daughter's condition and adjust treatment as necessary. If symptoms persist or worsen, further evaluation may be needed to rule out other underlying issues. Always prioritize her comfort and well-being, and do not hesitate to seek a second opinion if you feel uncertain about the treatment plan.

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