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Serous otitis media (Tympanic effusion)

Fluid behind the eardrum

Things to know about tympanic effusion

More prevalent in young children, serous otitis media (tympanic effusion) is usually linked to the presence of a common cold. To avoid secondary damage, if you suspect your child has an ear effusion, you should consult a doctor. Read about the symptoms, treatment, duration and complications that may arise if effusion of the ear is left untreated.

What is a Serous Otitis Media?

During an ear effusion, fluid collects in the middle ear. This, in turn, may lead to hearing loss as sound conduction is impeded by the fluid accumulated. Some sufferers of serous otitis media may also experience severe pain and dizziness and children are more likely to suffer from an effusion behind the tympanic membrane than adults.

Symptoms of fluid behind the eardrum

Fluid behind the eardrum occurs more frequently in childhood than adulthood. Reduced hearing (conductive hearing loss) is typical of fluid in the ear and, in most cases, will occur in both ears.

Additionally, serous otitis media in adults may also give rise to the following symptoms:

However, both reduced hearing and/or a feeling of pressure in the ear may also be indicative of tubal catarrh. 

What causes fluid behind the eardrum?

The causes of fluid behind the eardrum can vary greatly. Often, middle ear fluid occurs as a side effect of a cold. Because a cold disturbs the ventilation of the ear, mucus is produced in greater quantities. Within the ear, ventilation is provided by the Eustachian tube; however, in younger children, it is not yet fully functional, so ventilation is restricted. As the Eustachian tube increases in function with age; the older a child is, the better the ventilation and, hence, the incidence of tympanic effusion lessens.

Additional causes are strong fluctuations in air pressure: for example, during take-off and landing in an airplane.

Possible complications

  • If a tympanic effusion becomes chronic and treatment is not sought promptly, the inflammation can spread further. In some instances, if left untreated, fluid behind the eardrum may even lead to meningitis or mastoiditis.
  • Due to the prolonged hearing loss caused by liquid behind the eardrum, children often experience delays in speech development. 
  • If the condition is allowed to progress unchecked, the middle ear mucosa can calcify or scar, in some cases, even destroying the ossicles inside the ear. Should this occur, emergency surgery must be performed to replace them with an implant. 
  • In isolated cases, concomitant with the presence of middle ear fluid, retention pockets can form in the tympanic membrane, resulting in a cholesteatoma; a tumour only removable by surgery.
  • In very rare cases, mastoiditis, a bacterial inflammation, can also occur. In this case, the mastoid process of the temporal bone becomes inflamed. This condition should always be treated as soon as possible.
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How to get rid of fluid behind eardrum

A tympanic effusion generally resolves itself causing no further complications. Recovery from serous otitis media may take from as little as 3-4 days, to several weeks. However, if fluid in the ears persists for more than three weeks and remains untreated, it may become chronic giving rise to secondary damage requiring surgery. 

Diagnosis of a tympanic effusion

As with all ear complaints, at the first symptoms of a tympanic effusion, it is recommended you consult an ENT specialist. They will perform a thorough examination with an otoscope, checking the ear for changes and checking for fluid behind the eardrum. Should the eardrum be scarred from previous middle ear infections, fluid in the ears will not be visible but can only be detected by tympanometry. Tympanometry uses a measuring device to examine the eardrum and middle ear for disturbed pressure fluctuations, as well as the accumulation of middle ear fluid.

If fluid is present, the eardrum is often reddened and if the patient is in the chronic stage, the eardrum may be thickened and pinker in colour. Likewise, bloody, bluish, shimmering secretions are also symptomatic of chronic serous otitis media, whilst healthy secretions are amber in colour. In addition to the tympanogram, a tone audiogram, a detailed graphical representation of hearing in a hearing curve, is often performed to diagnose conductive hearing loss if disease is present. Similarly, a mirror examination of the pharynx, sinuses, and nasal cavity can provide information about an existing tympanic effusion.

Popular treatment methods

There are several options to treat a tympanic effusion:

  • Initial relief for fluid in the ear can be provided by mucolytic medications and decongestant nasal drops as these can improve oxygenation of the ear.
  • In the case of a bacterial infection, antibiotics and/or painkillers will be prescribed to prevent the inflammation from spreading further.
  • To avoid the need for surgery, various physiotherapeutic measures are available: inhalation and steam baths, heat treatment or rinsing of the nose are all suitable for this purpose.
  • In the event of a chronic tympanic effusion, the oxygen supply to the ear can be improved by the surgical insertion of a tympanic tube. 
  • Likewise, if the adenoids are enlarged due to chronic disease, an adenoidectomy can be performed to surgically remove them.
  • If a large accumulation of fluid is found in the middle ear, the eardrum can be incised and the fluid aspirated with a surgical procedure called tympanic membrane paracentesis.

Home remedies for fluid behind the eardrum

The symptoms of a tympanic effusion can vary in severity. If they are mild or temporary, there are many home remedies for fluid behind the eardrum available; likewise, you can also seek homeopathic treatment. To follow, some simple, home-remedies helpful for decongesting the sinuses: 

  • Nasal sprays and drops can provide relief for fluid in the ear.
  • Steam baths or inhalation with essential oils, such as eucalyptus, spruce or pine scent, as they have an expectorant and anti-inflammatory effect.
  • Red light as a heat treatment.
  • Nasal rinses, for example with salt water, which has anti-inflammatory and antibacterial effects.
  • Berries with a high vitamin C content (sea buckthorn, black currant, acerola and rosehip) can provide defence against infections.
  • Warm soups (chicken soup) to strengthen the immune system.
  • Warming pillow for the ear (with hay flowers) or a warm onion bag.


Should you prefer to treat a tympanic effusion naturally, then homeopathic treatment methods may be an option. However, before proceeding, you should seek the advice of your ENT specialist to verify whether additional medical therapy is also recommended. In homeopathic therapy there is no one, specific treatment for fluid behind the eardrum. To this end, before using homeopathic remedies, you should always address those symptoms physically present at the time. These can best be assessed by an experienced therapist. When treating tympanic effusion with homeopathic remedies, deep potencies, such as D6 to D12, are generally preferable. Whilst some remedies are more commonly used than others, homeopathic treatment for a tympanic effusion cannot be generalized to all sufferers. 

  • Apis mellifica for stabbing pain.
  • Aconitum is used for severe swelling and also for stabbing pain.
  • Pulsatilla as a supplement for children afflicted with fluid in the ear and who are particularly tearful, requiring attention and emotional support.

Available as both drops or tablets, these remedies can be purchased in pharmacies. Particularly well suited for children, they should be dissolved slowly under the tongue. For very young children, the same remedies can be dissolved in a little water and then dripped into the mouth.

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