Otitis media with effusion 

generally resolves spontaneously with watchful waiting. However, if

it is persistent, myringotomy with tympanostomy tube insertion is considered an effective
treatment. [13] In this treatment, a ventilation tube allows for air entry into the middle ear,
preventing re-accumulation of fluid. After this procedure, many patients do not need additional
therapy due to the growth and development of the Eustachian tube angle, which will allow for
drainage. 
Adenoidectomy is currently utilized in cases of OME that involve enlarged adenoids and is an
important addition to management in patients with OME. [14]
Childhood hearing loss can affect language development [15]. Therefore hearing aids may be
considered as a non-invasive option to treat OME. [16]
Clinician decisions for the correct interventional treatment of OME for a specific patient include
a variety of factors.
 Comorbidities of the patient
 The severity of hearing loss
 OME presence unilaterally or bilaterally
 Effusion duration
 Age of patient
Social factors
 Cost to patient
 Patient’s likelihood of adherence to treatment
 Familial assistance with treatment
A patient-focused approach should be adopted when assessing hearing disability. How the child
is coping socially and at school is more important than the results of audiometry
investigations. [17][18][19] Although most OME patients will warrant a conservative
management approach as opposed to more invasive interventions, all physical and social factors
should be examined to provide a patient-centered treatment plan that optimizes outcomes for the
patient

Otitis media dengan efusi umumnya sembuh secara spontan dengan menunggu dengan waspada. Namun,
jika menetap, miringotomi dengan pemasangan selang timpanostomi dianggap pengobatan yang efektif.
[13] Dalam perawatan ini, tabung ventilasi memungkinkan udara masuk ke telinga tengah, mencegah
penumpukan kembali cairan. Setelah prosedur ini, banyak pasien tidak memerlukan terapi tambahan
karena pertumbuhan dan perkembangan sudut tuba Eustachius, yang memungkinkan drainase.

Adenoidektomi saat ini digunakan dalam kasus OME yang melibatkan pembesaran kelenjar gondok dan
merupakan tambahan penting untuk penatalaksanaan pada pasien dengan OME. [14]
Gangguan pendengaran anak dapat mempengaruhi perkembangan bahasa [15]. Oleh karena itu, alat bantu
dengar dapat dianggap sebagai pilihan non-invasif untuk mengobati OME. [16]

Keputusan dokter untuk pengobatan intervensi OME yang benar untuk pasien tertentu mencakup berbagai
faktor.

Komorbiditas pasien
Tingkat keparahan gangguan pendengaran
Kehadiran OME secara sepihak atau bilateral
Durasi efusi
Usia pasien
Faktor sosial

Biaya untuk pasien

Kemungkinan kepatuhan pasien terhadap pengobatan
Bantuan keluarga dengan pengobatan
Pendekatan yang berfokus pada pasien harus diadopsi saat menilai ketidakmampuan pendengaran.
Bagaimana anak mengatasi masalah sosial dan di sekolah lebih penting daripada hasil penyelidikan
audiometri. [17] [18] [19] Meskipun sebagian besar pasien OME akan menjamin pendekatan manajemen
konservatif sebagai lawan dari intervensi yang lebih invasif, semua faktor fisik dan sosial harus diperiksa
untuk memberikan rencana perawatan yang berpusat pada pasien yang mengoptimalkan hasil untuk
pasien

Overview of Medical and Surgical Approaches

In general, inpatient care for otitis media with effusion (OME) is not required
unless complications that threaten the stability of the patient's condition are
suspected. Even surgical intervention with pressure equalization tubes (PETs)
and adenoidectomy is typically completed in ambulatory surgery settings.
A number of medical interventions have been suggested for the treatment of
otitis media with effusion, all with controversial but overall poor results.
Historically, if a middle ear effusion (MEE) persisted for 3 months, surgical
intervention was indicated. This dogma has been revised.
Autoinflation
Several investigators have reported mixed results when attempting to
determine if autoinflation, compared with no intervention, improves effusion
clearance rates. The ambiguity in the data may be a result of great variability
in autoinflation methods and/or noncompliance in patients. In a meta-analysis
of findings from 6 randomized controlled studies, results did reveal a benefit
with the use of nasal balloons for autoinflation in children.
An open, pragmatic, randomized trial by Williamson et al also supported the
efficacy of autoinflation, finding that in children with otitis media with effusion,
it cleared effusions and improved symptoms.  The study included 320 children
aged 4-11 years, who were treated either with a combination of autoinflation
(three times per day for 1-3 months) and usual care or with usual care alone.
The investigators reported that at 1 and 3 months, the rate of normal
tympanograms was higher in children in the autoinflation group.  The study
also found greater improvement in ear-related quality of life, in children and
parents, in the autoinflation group. [19]
Consultations
An otolaryngologist should be consulted whenever the primary care physician
(PCP) is concerned about persistent conductive hearing loss in children,
especially those with signs of language development delay.
In addition, an otolaryngologist (ENT) should be consulted if the disease is
recurrent, if the appropriate medical therapies available to the primary care
physician are exhausted, and/or if the criteria for surgical intervention have
been met.
An allergist, audiologist, and/or a speech therapist may be consulted, when
appropriate. In select cases, an immunologist may be consulted for the
workup for a possible immunocompromised state.