Why Do Adults Get Fluid in Their Ears?

While Uncommon, Adults Can Get Fluid Behind the Ear Drum

Adult woman being checked for an ear infection.
Adult woman being checked for an ear infection. Ariel Skelley / Getty Images

Fluid in the ears, also called serous otitis media, or otitis media with effusion, usually occurs when the auditory tube (also called the Eustachian tube) becomes clogged and is unable to drain. This tends to occur more frequently in children because they naturally have a more horizontal and more narrow auditory tube than adults. Even though fluid in the ears may be more likely to occur in small children it can occur in people of all ages

What Causes Fluid in the Ears

Causes of fluid in the ears are similar in both adults and children with some exceptions. The following are common causes of fluid in the ears of adults:

  1. auditory tube dysfunction
  2. allergies
  3. any kind of congestion from a cold virus or similar infection, or even pregnancy
  4. enlarged sinus tissue, nasal polyps, tonsils and adenoids, or other growths which block the auditory tube (usually caused by chronic sinusitis)
  5. exposure to chemical irritants, especially cigarette smoke
  6. damage to the auditory tube from radiation for head and neck cancer or previous surgeries which may transect the auditory tube (rare)
  7. barotrauma to the ears (rapid changes in ambient air pressure such as occur when flying in an airplane or scuba diving)

Auditory tube dysfunction must occur in some capacity in order for fluid to accumulate in the middle ear. Other listed causes of fluid in the ears typically lead to auditory tube dysfunction.

Adult Symptoms of Fluid in the Ears

Symptoms of fluid in the ears can range in severity by individuals. In small children the condition is often said to be symptomless, though it is more likely children of this age are just unable to express any discomfort and in the absence of severe ear pain most symptoms go unnoticed by their caretakers.

For most adults experiencing fluid in the middle ear symptoms may be subtle, but some adults report constant ear pain and debilitating symptoms. Some adults and older children who have had persistent problems with chronic fluid in their ears can sometimes tell when the fluid has re-accumulated and they are in need of treatment. In general, symptoms of fluid in the ears may include:

Diagnosing Fluid in the Ears

Diagnosing fluid in the ears can be difficult in some cases and usually requires the expertise of a specialist, called an otolaryngologist. This is a doctor who specializes in the care of the ear, nose, and throat. An experienced otolaryngologist can sometimes tell if there is fluid in the ears by using an otoscope and visualizing the eardrum.

If there is fluid behind the eardrum the doctor may see a fluid line, bubble, notice that the eardrum is not the right color, or see that the eardrum is slightly retracted.

A test called tympanometry may also be used to diagnose fluid in the ears. During this test a probe is placed inside the ear canal. The probe delivers sound waves into the ear and also creates both positive and negative ear pressure within the ear canal. The energy that is returned by the eardrum is measured as a waveform, the waveform of someone with fluid in their ears will appear differently than someone who does not.

Hearing tests may also be used to detect fluid in the ears.

Treatment

There are really only two ways to treat fluid in the ears: wait and see if the fluid goes away on it's own, or the surgical insertion of ventilation tubes.

If your symptoms are not too bothersome your doctor may choose to wait and see if the fluid goes away by itself. If the fluid does not clear up on it's own or if your symptoms are too severe your doctor may choose to insert synthetic tubes in your ears to hold the auditory tube open and allow the fluid to drain out. For more information about this procedure read: Ear Tube Placement in Adults

It should be noted that most adults who get fluid in the ears have an underlying disorder that is causing auditory tube dysfunction. The underlying disorder should also be identified and treated.

Can Fluid in the Ears be Prevented?

Fluid in the ears can sometimes be prevented, controlling congestion is a good way to start. You can do this by treating allergies properly and using a decongestant such as pseudoephedrine when you get a cold. It is also helpful to avoid chemical irritants such as cigarette smoke.

Sources:

Medline Plus. Otitis media with effusion. Accessed: April 27, 2015 from http://www.nlm.nih.gov/medlineplus/ency/article/007010.htm

Medscape. Otitis Media With Effusion. Accessed: April 27, 2015 from http://www.medscape.com/viewarticle/572688

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