Secretory otitis media (SOM), also known as “otitis media” with effusion or “glue ear”, is an extremely common ear condition in children. The condition is characterised by the collection of non-infected fluid in the middle ear space. This fluid dampens the movement of the eardrum leading to a sensation of ear blockage and loss of hearing. 

It is common among children aged 6 months to 3 years. Around 90% of children experience SOM at least once by the age of 10, according to the Agency for Healthcare Research and Quality.

SOM is not the same as acute otitis media (AOM, ASOM), which is an infectious condition associated with ear pain, or chronic suppurative otitis media (CSOM), which usually has accompanying ear discharge. The most common misconception is that water in the ear can cause SOM, which is not true. 

Read on to know about the causes, symptoms, and treatment of secretory otitis media.

What Causes SOM?

SOM is more common in children due to the shape of their eustachian tubes, canals that connect the middle ear with the throat. Children’s eustachian tubes are shorter and have smaller openings. Thus, fluid drainage from the middle ear becomes more difficult. This increases the possibility of blockage and infection during cold and other viral infections. 

Other causes are:

  • Respiratory infection, allergies, and air irritants.

  • Change in air pressure, especially while flying in an airplane or by drinking fluids while lying down.

  • Enlarged adenoids (lymphoid tissue collections located where the throat and nasal passages meet) that may lead to blockage of the eustachian tube.

What Are The Symptoms of SOM?

SOM symptoms may differ from child to child. This condition is usually painless. Nevertheless, fluid buildup can cause symptoms such as:

  • Hearing problems.

  • Feeling of fullness in the ear.

  • Pulling or tugging on one or both ears.

  • Popping in the ear while swallowing.

How is SOM diagnosed?

The doctor will examine your child’s ear by using an instrument called an otoscope. It is a magnifying glass with a light attached at one end that is used to look into the ear.

Other diagnostic tests are:

  • Tympanometry: The doctor inserts a probe into the ear to measure the amount and thickness of fluid behind the eardrum. 

  • Audiometry: It is done to find out about hearing levels and advised in children above 3 years of age.

How to Treat SOM?

Treatment of SOM depends on many factors. It often resolves on its own within 2 to 3 weeks. Treatment methods include medications and surgery. 


Antibiotics (medicines that kill/stop the growth of bacteria) may be prescribed if your child has an upper respiratory infection accompanying the SOM. 

The doctor may also prescribe decongestants and anti-allergic medications if your child has an allergy.


1. Myringotomy: If your child has had SOM for more than 2 or 3 months and there is concern that the decreased hearing caused by the fluid is affecting speech development, your child's doctor may recommend a myringotomy.

It is a surgical procedure in which a small opening is made in the eardrum to drain the fluid and alleviate pressure in the middle ear. A small tube is inserted into the eardrum opening to allow air to enter the middle ear and prevent fluid accumulation. After the fluid is drained, your child's hearing will be restored. 

2. Adenoidectomy: It is a procedure in which the adenoids are surgically removed if they are infected.

SOM usually does not cause long-term damage. However, if your child develops recurring and frequent ear infections, consult a doctor to discuss treatment options and ways to prevent further infections.

Disclaimer: This article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.