What to Do for Fluid in the Ear

Medically Reviewed By William C. Lloyd III, MD, FACS
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Older Caucasian woman getting ear exam from female Caucasian ear, nose and throat doctor

Normally fluid in the ear drains out through the Eustachian tube, the narrow tube behind the eardrum that connects to the back of the nose and throat. The fluid drains out into the back of the throat to prevent buildup in the ear, where bacteria can grow and cause an infection. This infection is called acute otitis media, also known as a middle ear infection. However, the buildup of fluid in the ear doesn’t always cause infection, which is a condition called otitis media with effusion. Learn what to do for fluid in the ear, whether it has caused an infection or not.

Acute Otitis Media

When fluid in the ear doesn’t drain properly out of the Eustachian tube, it can build up in the middle ear, just behind the eardrum. This fluid buildup gives bacteria a place to grow, which can cause an infection. Middle ear infections are common in babies and children age 2 and younger because their Eustachian tubes are shorter, more horizontal, straighter and more easily clogged than in adults. However, ear infections can affect people of any age, especially as a complication of allergies, a cold, or a sinus infection, which may cause swelling in the Eustachian tube that results in blockage, preventing the fluid from draining.

What to do for acute otitis media

Some ear infections will clear up on their own without treatment. Pain management may be all that’s needed to let the body fight the infection. Applying a warm cloth to the infected ear and using over-the-counter pain relievers may be enough to help manage the pain until the infection clears up. You can buy anesthetic ear drops over the counter, but don’t use these if there’s a hole or tear in the eardrum. Ibuprofen and acetaminophen are appropriate pain relievers for kids, but never give a child aspirin due to the risk of Reye’s syndrome.

However, anyone with severe ear pain or a fever higher than 102 degrees Fahrenheit needs to be evaluated by a doctor. The doctor may prescribe antibiotics to fight the ear infection.

If ear infections become a recurring problem, the doctor may want to put tubes in the ears. This is performed with a myringotomy, in which the surgeon creates a small hole in the eardrum to drain fluid from the middle ear. Then the doctor inserts a tiny tube into the eardrum to equalize the pressure on both sides of the eardrum.

Otitis Media With Effusion

Also called fluid in the middle ear, otitis media with effusion is the buildup of fluid in the ear without an infection. This can sometimes occur when a middle ear infection has not completely healed or there is fluid left over from a cured infection. This condition is also common in young children, but it can occur in older children too. Because there’s no infection and no pain, the child usually doesn’t act sick or have other symptoms. Some may complain of muffled hearing, which is due to the fluid.

Even though there’s no infection, otitis media with effusion can cause other problems, such as making it more difficult for the person to hear. In children, this can sometimes result in speech and language development problems, but long-term effects of otitis media with effusion are rare unless the condition becomes chronic.

What to do for otitis media with effusion

Most of the time, otitis media with effusion doesn’t need treatment and usually goes away within a few months. Antibiotics won’t be effective because there’s no infection. Decongestants or antihistamines can help relieve congestion, but they won’t make the fluid in the ear drain. As a temporary fluid in the ear treatment to relieve pressure, you can use the Valsalva maneuver to increase pressure behind your eardrum. To do this, pinch your nostrils shut and gently try to breathe out through your nose, as if you were blowing your nose. A doctor can also use a middle ear inflator to increase pressure in the middle ear. But neither of these treatments cause fluid in the ear to drain.

For children over age 1, stopping the use of a pacifier during the day may help fluid in the ear go away.

If otitis media with effusion becomes a chronic problem, meaning it continues for three months or longer, the doctor may want to surgically insert tubes in a child’s ears to drain the fluid.

Acute Otitis Externa

Acute otitis externa is another type of ear infection that affects the ear canal rather than the middle ear. This type of infection is often called swimmer’s ear because getting water in the ears during swimming is a common cause. Other common causes include getting irritants like hairspray in the ear, using unclean earplugs or hearing aids, or injuring the ear canal. An ear canal injury can happen using a cotton swab to clean it, and doctors recommend never putting cotton swabs in the ears. A fungus can also cause acute otitis externa, but this is less common.

What to do for acute otitis externa

Your doctor will remove any debris in the ear canal. For mild infection, ear drops with vinegar and corticosteroids can help clear the infection. Your doctor may prescribe antibiotic ear drops for a more serious infection. Taking ibuprofen and acetaminophen can help manage the pain until the ear infection starts to get better. Keep the ear dry until the infection clears up. You may need to use earplugs along with a shower cap or swimming cap to keep the ear dry when showering or swimming.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Jul 1
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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