Fluid collection in the middle ear is either due to inadequate functioning of the eustachian tube which transmits air into the middle ear, or untreated otitis media. In children, it is often accompanied with enlarged and infected adenoids . Parental smoking at home and air pollution are also causative factors. Fluid in the middle ear not resolving within 3 months despite medications should be treated surgically, as it can lead to permanent hearing loss and chronic middle ear infections, when left untreated. 

Middle ear and Eustachian tube 

The middle ear is an air filled space just behind the ear drum. When the eardrum vibrates, the sound is transmitted to three small ossicles in the middle ear, the inner ear, auditory nerve and the brain. A small tube called “eaustachian tube” which lies between the back of the nose (nasopharynx) and middle ear, equalizes pressure between two sides of the eardrum. 

Bacteria or viruses can reach the middle ear through the eustachian tube and cause middle ear infection. In case middle ear infections are not treated or recurrent infections occur, fluid may accumulate within the middle ear. This fluid alone does not harm the ear; but it causes mild hearing loss and may cause new middle ear infections.

What are the signs od middle ear fluid?

Fluid collection in the middle ear is usually a silent problem. Frequently, the only symptom is mild hearing loss which may not attract parents’ attention in children. Listening TV loudly and decreased attention should suggest hearing loss due to fluid collection in the middle ear.

How is middle ear fluid diagnosed?

Your doctor will look into your child’s ear with a lighted instrument called an otoscope or microscope, and will ask for some ear tests if necessary.

Treatment of middle ear fluid – When is surgery required?

You may have heard that many children have ear tubes; however, surgical treatment is not the first choice of treatment for middle ear fluid. Watchfull waiting for 3 months results in spontaneous resolution in many patients. Medications or modified Politzerization may help middle ear ventilation, during the waiting period.


Modified Politzerization method, provides air to reach the middle ear with the help of a device which gives air at a certain pressure through the nose and eaustachian tube. Many patients benefit from this method and surgery can be avoided. If you need detailed information about this procedure, please leave a message.

If the fluid in the ear does not resolve within 3 months, your doctor may recommend ventilation tube insertion into the eardrum, which is a surgical procedure performed under general anesthesia.