Otitis Media with Effusion In Children Winter has always been the flu’s favourite season, and this year’s no difference. Many young patients visit my clinic with yellow mucus dangling from their nostrils, some with coughing, and some with fevers; but most recovers fast after treatment. However, the few with “otitis media with effusion (OME)” (water clogged in the middle ear region) would require a little more care and patient. Usually after hearing that their children have otitis media with effusion, the first reaction of many parents is to blame themselves for letting the water enter their child’s ear during shower. However, this is rarely the case, as I often explained: “With the presence of ear drum, the water from showering doesn’t enter the middle ear region. What connects the middle ear to the outside is the Eustachian/auditory tube; it connects the middle ear to the back of our nose. Because the angle of the Eustachian tube in children is relatively more flat or horizontal, it’s therefore easier for virus to enter the middle ear through upper respiratory channel, and give children a higher chance to have Otitis Media (middle ear inflammation) or Otitis Media with Effusion.” The threat of Otitis Media with Effusion is mainly the blockage of the transmitting of sound, and causes a minor hearing disorder; basically reduces one’s ability to hear well. In daily life, parents may sometimes wonder: “How come my child only replies after I raise my volume? Why does he turn the TV so loud? Why is the teacher telling me my child has been less concentrated in class recently? Why is my child falling behind on school work recently?” Many parents overlooked this “minor” hearing problem. To experience what it feels like to have Otitis Media with Effusion, simply block your ears with your fingers and try to have a conversation with someone else. Most young patients with “Otitis Media with Effusion” can be cured after 1 to 2 weeks of medicine treatment. In the case of the few that don’t recover or have relapse right after the cure, then further examination may need to be carried. The adenoid body behind their nose should be checked to see if it has enlarged and blocked the opening of Eustachian tube. Or if it’s sinusitis and other chronic nasal disease that caused the Eustachian tube to be inflamed. If the adenoid is enlarged (adenoidalhypertrophy), then I would recommend a surgery to have it removed. Most parents get worried after hearing about surgery, but I usually explain that: “While adenoid is part of the immune system, its function gets replaced gradually by the others after the child is 3 years old, so the removal of adenoid would not reduce the child’s immune system. If the Otitis Media with Effusion is caused by chronic nasal/sinus disease, then our target should be the nose. Because young children’s nose still at a developing stage, surgery is not recommended. I usually use pulsatile nasal irrigator to rinse the children’s nasal cavity and sinus, alongside with traditional medication. Once the nose is solved, Otitis Media with Effusion will then cure itself gradually. About 70% of children before the age of 3 have had some degree of Otitis Media with Effusion, so next time when you wonder why your child isn’t responding to your right away or is concentrating less in class, go check to see if OME has blocked your child’s ears.