Objectives: Otitis media with effusion are defined as the persistence of middle ear effusion for more than 3 weeks. If the diagnostic is easy, questions remain about pathogeny and treatment.
Materials and methods: Literature was reviewed regarding the pathogeny and the best treatment strategy.
Results: Except in the case of middle ear effusion due to trauma, effusion is an exudate due to mucous cell metaplasia. The main causal factor is middle ear inflammation, which is secondary to viral or bacterial infection. Inflammation causes dysfunction of the sodium transports in the middle ear. Responsibility of the otitis media with effusion in the genesis of the various chronic otitis media remains controversial. Treatment is justified when otitis media last more than 3 months, that is to say few months observation is required. The aim of treatment is to reduce local inflammation and to treat effusion. Prevention and treatment of local inflammation is difficult. Indeed, it is difficult to avoid rhinitis that is mainly viral. Effusion must be treated in order to avoid local middle ear deterioration and language deficiency. Insertion of tympanostomy tube is the only effective treatment. It decreases middle ear depression and Eustachian tube obstruction and restores the mucociliary clearance. Adenoidectomy and amygdalectomy are not effective in otitis media with effusion but, in association with tympanostomy tube, could decrease recurrence of acute otitis media.
Conclusion: Otitis media with effusion remains a frequent disorder, for which the only effective treatment is the tympanostomy tube.