What Causes Accumulation of Fluid in the Ear?

Table of Contents
View All
Table of Contents

Serous otitis media (SOM) is a buildup of fluid behind the eardrum. It's also known as otitis media with effusion (OME). It happens when the auditory tube is blocked.

The auditory tube is also known as the eustachian tube. It allows fluid to drain from the ear into the back of the throat. If the flow is blocked, fluid can be trapped in the middle ear space. This fluid is called effusion.

Ear infections, colds, and allergies can all cause inflammation or mucous to block the auditory tube.

This article explains what else could cause fluid buildup, how to prevent it, and how to diagnose and treat the condition.

causes of fluid accumulation in the ear

Verywell / Emily Roberts

Causes

Anyone can get fluid in their ears. It is much more likely to occur in children because their auditory tubes are smaller. In a child's ears, the tubes also run in a more horizontal direction than in an adult ear.

There are about 2.2 million cases of OME in the U.S. each year. About 90 out of 100 children will get fluid in their ears at some point before they reach 5 or 6 years old.

Fluid in the ears is caused by some form of auditory tube dysfunction. Common causes include:

  • Allergies
  • Congestion from a cold virus, infection, or even pregnancy
  • Enlarged sinus tissue, nasal polyps, tonsils, adenoids, or other growths that block the auditory tube (usually caused by chronic sinusitis)
  • Chemical irritants like cigarette smoke
  • Damage from radiation for head and neck cancer
  • Surgeries that cut across the auditory tube (rare)
  • Barotrauma to the ears (rapid changes in air pressure around you, such as when you're flying in an airplane or scuba diving)
  • Oral differences that can occur with Down syndrome or cleft palate

Symptoms

Symptoms range in severity from person to person. Small children may have no symptoms or may not be able to express them. If the child's ear pain isn't severe, caretakers might not even notice the problem.

For adults, pain can be subtle, constant, or even debilitating. If you've had fluid in your ear before, you may be able to tell that it's built back up again and you need treatment.

Symptoms of fluid in the ears may include:

  • Ear pain
  • Feeling like the ears are "plugged up"
  • Increasing ear pain when changing altitude, and being unable to "pop" the ears
  • Tinnitus (ringing in the ears)
  • Hearing loss or the sensation that sounds are muffled
  • A feeling of fullness in the ears
  • Loss of balance or vertigo (rare)
  • Behavior problems
  • Poor school performance related to hearing loss

Some conditions cause similar symptoms as fluid in the ear. Some may be present at the same time as fluid in the ear, including:

  • Middle ear infections
  • Ear drainage
  • Ear barotrauma
  • Earache

Diagnosis

Because OME doesn't always show symptoms, it often goes undiagnosed. If your child has symptoms of fluid in the ear, it is best to take them to a healthcare provider, pediatrician, or an otolaryngologist (ear, nose, throat specialist or ENT).

A specialist may have better diagnostic equipment. Even more importantly, their experience allows them to recognize subtle clues that might mean fluid is trapped in the ear.

Otoscope Exam

The best method for diagnosing this condition is an ear exam using a handheld tool called an otoscope or otomicroscope. Otoscopes are more common because they're less expensive. Otomicroscopes may allow for more accurate diagnosis.

Checking the ear with an otoscope is very simple. The healthcare provider pulls back the ear and gently inserts the tip of the otoscope. The scope brings the eardrum into view. Experienced physicians can see either a bubble or fluid level behind the eardrum. They may also see that the eardrum doesn't move like it should.

Sometimes the only thing indicating fluid in the ear is a slight retraction of the eardrum or a slightly abnormal color. That's why it takes a skilled physician to diagnose the condition.

Tympanometry Exam

Fluid in the ear can be confirmed by another test called tympanometry. This test is similar to an otoscope exam, but the healthcare provider uses a tool called a speculum. It's placed in the outer ear canal. It's important to hold very still during this test and avoid speaking or swallowing if possible.

The instrument measures the pressure inside the ear, then generates a tone. The tympanic membrane (eardrum) reflects some of the sound back into the tympanometer. If there is fluid in the ear, the eardrum will stiffen and an abnormal amount of sound will be reflected.

Treatment

You may not need any treatment for fluid in the ears. The fluid usually drains on its own within a few weeks. If it doesn't, treatment will depend on several factors.

  • If the fluid is present for six weeks, treatment may include a hearing test, a round of antibiotics, or further observation.
  • If the fluid is present after 12 weeks, you should have a hearing test. If there is significant hearing loss, a healthcare provider may consider antibiotics or placing tubes in the ears.
  • If the fluid is still present after four to six months, you may need to have tubes placed in your ears surgically, even if you don't have much hearing loss.
  • If your adenoids are so large that they block your auditory tubes, they may need to be removed.

You can have fluid in your ears with or without an active infection. If you don't have an ear infection, your healthcare provider won't prescribe antibiotics. Antihistamines may help to prevent allergy symptoms and chronic sinusitis from clogging your ears, but they won't necessarily rid your ears of fluid that's already present.

Children who are at a higher risk of complications, including those with developmental delays, may need earlier treatment. If your child doesn't need treatment, it may be best to manage symptoms and wait for fluid to clear up on its own. Whether or not a child has surgery, this condition usually resolves completely.

Prevention

These steps may help to prevent fluid in the ear:

  • Avoid cigarette smoke.
  • Avoid allergens (substances that trigger your allergies).
  • If your child is in daycare, consider switching to a smaller daycare if ear fluid is a frequent problem.
  • Wash your hands and your child’s toys frequently.
  • Avoid overusing antibiotics.
  • Consider breastfeeding if possible, even for just a few weeks. Infants who are breastfed get sick less often and are less likely to get ear infections even years later.
  • Stay up to date on vaccines. The pneumococcal vaccine (Prevnar) helps prevent the most common type of ear infections. The flu vaccine may help as well.

Contrary to popular belief, getting water in a baby's or young child’s ears will not cause serous otitis media. Children who swim frequently and do not dry their ears enough may get swimmer's ear, which is a completely different condition.

Summary

Otitis media with effusion is the medical term for fluid buildup behind the eardrum. It happens because something--inflammation, mucous, a growth, or a structural problem--blocks the drainage of fluid from your auditory tube.

You may or may not have symptoms. If you do, you might feel pain or notice changes in how things sound. Many times, fluid in the ear gradually goes away on its own. If you have an infection, you may need antibiotics. If the problem persists, you might need surgery to help drain the fluid.

Simple strategies may help prevent fluid buildup: Avoid irritants and allergens. Wash your hands. Keep toys and play areas clean. And make sure to get all recommended vaccines.

A Word From Verywell

Fluid in the ear is a common problem, especially for young children. Whether you are an adult or a child, the fluid in your ear will likely resolve without treatment.

If your symptoms have lasted for more than six weeks or are causing significant symptoms, you should see a healthcare provider. Untreated fluid in the ear can impact your quality of life and performance at school or work.

Frequently Asked Questions

  • How long does it take for fluid in the ear to go away in adults?

    It can take up to three months for fluid in your ear to clear up on its own. If you continue to have problems, your doctor may prescribe antibiotics and look for an underlying problem that might require different treatments.

  • How do you remove water stuck in your outer ear?

    Tugging on the earlobe and shaking your head should help water flow out of the ear canal. You can try to create a vacuum with the palm of your hand. Using a solution that's 50% rubbing alcohol and 50% white vinegar after swimming can also dry the ear canal and may prevent infections caused by swimmer’s ear.

  • Is it normal to have fluid drain from your ear?

    Earwax that drains from your ear is normal. This can be white, yellow, or brown. It may be runny. Only a small amount should drain from the ear, though. If discharge continues or if you see signs of blood or pus, it may indicate your eardrum has ruptured. That's not normal, and you should contact your healthcare provider.

Was this page helpful?
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Kwon C, Lee HY, Kim MG, Boo SH, Yeo SG. Allergic diseases in children with otitis media with effusion. Int J Pediatr Otorhinolaryngol. 2013;77(2):158-61. doi:10.1016/j.ijporl.2012.09.039

  2. Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M. Update on otitis media - prevention and treatment. Infect Drug Resist. 2014;7:15-24. doi:10.2147/IDR.S39637

  3. Núñez-Batalla F, Jáudenes-Casaubón C, Sequí-Canet JM, et al. Diagnosis and treatment of otitis media with effusion: CODEPEH recommendations. Acta Otorrinolaringológica Española. 2019;70(1):36-46. doi:10.1016/j.otorri.2017.07.004

  4. Tufts Medical Center. Ear: Swimmer’s (otitis externa).

  5. Gao T, Li X, Hu J, et al. Management of traumatic tympanic membrane perforation: a comparative study. Ther Clin Risk Manag. 2017;13:927-931. doi:10.2147/TCRM.S139631

Additional Reading