Both children and adults can suffer from a tympanic effusion. Typical for this ear disease are a feeling of pressure and pain in the ear or even hearing loss. The non-contagious disease is easily treatable and curable. We inform you in this article how to recognize a tympanic effusion – in distinction to a middle ear infection – and how to treat it both with conventional medicine and with home remedies.
How does a tympanic effusion manifest itself?
A tympanic effusion is usually accompanied by the following symptoms:
- A tympanic effusion primarily causes a feeling of pressure or fullness in the ear. Cracking noises are also described.
- Later, pain of the affected ear develops. The pain is rather dull and anchored in the depth of the ear.
- Another typical symptom is hearing loss on the affected side. In young children, the impaired hearing can lead to a delay in speech development in the long term.
- If the eardrum is injured, it may happen that turbid fluid runs out of the ear.
- Often, the tympanic effusion is triggered by an infection of the upper respiratory tract and then accompanied by appropriate complaints such as fever, aching limbs, cold and cough.
Fluid in the ear in tympanic effusion
In tympanic effusion, fluid (secretion) fills the middle ear (auris media, also called the tympanic cavity). The tympanic cavity represents the connecting space between the inner ear and the outer ear and has the task of transporting acoustic sound waves arriving from the outside world toward the inner ear with the help of the vibrating eardrum and the ossicles. The inner ear contains the actual hearing organ, the cochlea. Due to the fluid in the tympanic cavity, sound cannot be adequately transmitted to the inner ear, resulting in hearing loss.
Pain in the ear in tympanic effusion
In addition, pressure equalization with the so-called eustachian tube does not function properly. The eustachian tube (“Eustachi tube”) is an air-filled connecting passage from the nasopharynx to the middle ear. The commonly known pressure equalization by pressing with the mouth closed while holding the nose shut is a maneuver to open the Eustachian tube and allow air pressure to escape from the middle ear. If this mechanism is disrupted by fluid in the middle ear, the increase in pressure causes pain in the middle ear.
What causes tympanic effusion?
The fluid in the tympanic cavity forms due to a ventilation disorder of the middle ear and eustachian tube, in children usually caused by growths of glandular tissue in the nasopharynx (“adenoids”, popularly known as “polyps“). Affected are the glands of the so-called pharyngeal tonsils, which are not to be confused with the palatine tonsils. Often these polyps, which are harmless in themselves, are only discovered by a tympanic effusion, before which they do not cause any problems. Due to the ventilation disorder, the mucous membrane cells of the middle ear change and produce more thick, viscous mucus. Thus, a tympanic effusion is not a disease that is contagious.
Adult tubal catarrh
In adults, viral infections of the sinuses (“rhinitis” or “sinusitis“) are often to blame. The common cold causes the mucosa to swell, and it also causes a ventilation disorder of the eustachian tube and middle ear. The resulting inflammatory secretion is called “tubal catarrh” by physicians (“-tube”=tuba auditiva=ear trumpet, “-catarrh”=fluid accumulation) and is a precursor of tympanic effusion.
Other causes of tympanic effusion
Allergies and curvatures of the nasal septum can also cause a tympanic effusion. In very rare cases, and almost only in adults, ventilation problems caused by malignant tumors are the cause. These are usually cancers (“carcinomas”) of the mucosa of the nasopharynx. Congenital malformations, such as cleft lip and palate, also predispose to tympanic effusion.
How long does a tympanic effusion last?
A distinction is made between acute, i.e., suddenly occurring and thereby lasting a short time, and chronic (long-lasting) forms of progression. In children, chronic courses, sometimes recurring within a few months, are typical. Over time, the composition of the secretion also changes, it becomes more viscous and thicker and drains even more poorly.In adults, where a short-lasting viral infection is more often the cause, acute illnesses that heal on their own after a few days to weeks are more likely to be observed.
Tympanic effusion – what to do?
Especially if children are affected, who can not exactly name their complaints, you should contact a doctor. This can look into the ears (“otoscopy”) and see a retraction or injury of the eardrum or even the secretion behind the eardrum. He can also test the vibration ability of the eardrum (“tympanometry”) and thus make a statement about the extent of the tympanic effusion. Furthermore, a hearing test can be informative. Causative polyps can be detected by a reflection of the nasopharynx.
How is a tympanic effusion treated?
If the doctor detects a tympanic effusion, the treatment depends on the cause. An acute tympanic effusion from a viral infection usually heals on its own within two to three weeks and has a good healing tendency. Decongestant nasal drops or nasal sprays, as well as mucolytic medications, can be used to relieve symptoms. This reduces overall pressure on the sinuses and relieves pain. Direct analgesics are also used.
Tympanic effusion in infants and children
In children, a wait-and-see approach is also preferred initially, because even a chronic tympanic effusion due to adenoids may resolve on its own within a few months. Here, too, the above-mentioned decongestant and pain-relieving measures and medications have a supporting effect. However, if a relevant hearing loss is added, the tympanic effusion should be relieved – especially if speech development is at risk. Likewise, action should be taken if the child suffers from recurrent tympanic effusions.
Paracentesis as a therapy for tympanic effusion.
Relief involves surgery to make an incision in the eardrum (“paracentesis”), suctioning out the effusion and, if necessary, inserting a so-called “tympanostomy tube.” This is a thin tube made of metal or plastic through which the fluid can drain to the outside until the ventilation of the middle ear is restored to normal. The tympanostomy tube is then either removed by the doctor or it falls out on its own.
Treatment with tympanostomy tubes – what to consider
It is important to be careful when handling water during the time of therapy. If water were to run over the tube into the middle ear, an infection could form. For swimming, therefore, some otolaryngologists and pediatricians recommend wearing earplugs. There are also exercises during sports that are not recommended with the tympanostomy tube in place.
Flying with a tympanic effusion
Due to the increased air pressure, traveling by air is also not recommended if you have a condition with a tympanic effusion. It is best to talk to your treating physician about this.
Surgery for tympanic effusion
If adenoids, or polyps, have been detected, they are removed by surgery (“adenotomy”). This involves cutting away the enlarged adenoids. Often, the described eardrum incision and, if necessary, the insertion of a tympanic tube can be performed in the same session. Usually, this surgery can be done on an outpatient basis.
Home remedies for tympanic effusion
Especially if it is a mild form of a tympanic effusion and a temporary tympanic effusion in a viral infection, certain home remedies can support the healing in addition to the recommendations of the ENT doctor. To decongest the sinuses, the following tricks can help in treating it:
- Nasal drops or nasal sprays
- Steam baths
- Inhalations
- Red light
- Nasal rinses
Essential oils with eucalyptus, spruce or pine fragrance have an expectorant and anti-inflammatory effect and are therefore well suited for use in a steam bath or for inhalation.
Treating tympanic effusion homeopathically
Homeopathy is recommended for a tympanic effusion only as a support to conventional medicine. Homeopathic remedies are unlikely to provide relief for ventilation problems caused by adenoids. If you are interested, talk to your attending physician about the possibilities of using globules or Schüßler salts
for the supportive therapy of the tympanic effusion. Also with questions to the Osteopathie with the tympanic effusion it is advisable to catch up the opinion of the physician of your confidence.
Middle ear infection or tympanic effusion?
Distinguishing a middle ear infection (“otitis media“) from a tympanic effusion is sometimes not easy. Especially since a tympanic effusion can also form as a result of a middle ear infection. Otitis media is an inflammation of the mucous membrane of the middle ear caused by bacteria or viruses, which is accompanied by symptoms such as fever, chills, weakness and pain. In case of ear pain that is very severe or lasts longer than two days, fluid secretion from the ear or hearing loss, it is essential to consult a doctor. In the case of a middle ear infection, the doctor may then prescribe an antibiotic.