Management of otitis media with effusion present for less than 3 months

In children with otitis media with effusion, 90% of effusions will have resolved spontaneously by 3 months. If the child has normal hearing and is not at risk for speech or language problems, it is appropriate to manage the effusion with observation.

Refer to an otolaryngologist if an effusion is associated with speech delay or learning problems, or if there is structural damage to the tympanic membrane (eg significant retraction, cholesteatoma). A tympanostomy tube restores hearing in the short term, but long-term improvement in learning has not been demonstrated.