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Tympanic effusion: fluid behind the eardrum

Tympanic effusion is an accumulation of fluid in the tympanic cavity, which is part of the middle ear. If excessive fluid accumulates behind the eardrum, it can impair hearing as sound conduction is restricted. Treatment methods range from simple household remedies to surgical procedures. You can find out everything about the causes, symptoms, diagnosis and treatment of tympanic effusion in this article.

Water behind the eardrum - tympanic effusion symptoms

Tympanic effusion is not conventional water that has run behind the eardrum, but the body's own secretions that are prevented from flowing out. However, water in the ear canal is also a common phenomenon, for example after swimming or bathing. However, it should not be confused with tympanic effusion. It is therefore important to know the signs of tympanic effusion.

In the beginning, a tympanic effusion usually manifests itself as a pressure sensation in the ear, sometimes accompanied by pain. In addition, there is an increasing hearing impairment - the patient's own voice is often perceived as unusually loud, while the rest of the hearing is reduced. Other possible symptoms are:

In children, the accumulation of fluid sometimes remains undetected for a long time. The potentially resulting hearing loss can in turn be reflected in a delay in speech development.

Causes of tympanic effusion

Normally, the tympanic cavity is an air-filled space that is closed to the outside and is part of the middle ear. It is connected to the nasopharynx via the Eustachian tube (tuba auditiva). As the middle ear is lined with mucous membrane, which absorbs air, mucus production takes place in it. There is therefore a constant slight negative pressure in the cavity, which must be equalized via the auditory tube. The pressure equalization takes place unnoticed during the swallowing process. If ventilation is obstructed, the vacuum increases and the secretions do not drain into the nasopharynx. As a result, the middle ear fills with secretions and a tympanic effusion occurs.

The causes of tympanic effusion are:

  • Enlarged or inflamed adenoids
  • Infections of the upper airways, e.g. sinusitis and rhinitis
  • Allergies
  • Chronic sinusitis
  • Curvature of the nasal septum
  • Tumors
  • Strong pressure fluctuations, e.g. during airplane landings

Tympanic effusion middle ear infection

Tympanic effusion can occur as a result of inflammation of the middle ear. This is due to the fact that the ear trumpet may be constricted as a result of the middle ear inflammation. The consequence is a ventilation disorder, which leads to the accumulation of secretions.

Diagnosis of tympanic effusion

First of all, a patient consultation is carried out with the ear, nose and throat specialist in order to make a diagnosis, followed by an ear examination. When examining the ear, the doctor checks whether there is an accumulation of fluid behind the eardrum. In most cases, a high fluid level can be easily recognized, but in some cases there are limitations to the assessment. It becomes problematic, for example, if there is scarring of the eardrum as a result of middle ear inflammation.

If the fluid level is not visible, a tympanometry provides further information. In this test, a measuring device checks the reaction of the eardrum and middle ear to pressure fluctuations in order to draw conclusions about an accumulation of fluid. In addition, a hearing test shows whether there is a sound conduction disorder. The nasopharynx and pharynx can also come into focus for a comprehensive examination. In some cases, ultrasound or x-ray of the paranasal sinuses complement the diagnosis.

Tympanic effusion in adults

Tympanic effusion occurs more frequently in children. This is due to the fact that children's ear ventilation is not yet fully developed. However, tympanic effusion can also occur in adults. This is particularly common in the course of a cold.

Tympanic effusion treatment: removing fluid behind the eardrum

If the symptoms do not resolve after a few days to weeks, various treatment methods can help, ranging from simple irrigations and sprays to surgical procedures. Treatment options include:

  • Medication to loosen mucus and decongestant nasal drops
  • Antibiotics or painkillers (for bacterial infections)
  • Inhalation/steam baths, heat treatment
  • Insertion of a tympanic tube (for chronic tympanic effusion)
  • Tympanic membrane incision (for severe fluid accumulation)

Tympanic effusion home remedies

If tympanic effusion occurs as a result of a viral infection, home remedies can be used for supportive treatment. In particular, steam baths, inhalation, red light and nasal rinses are suitable for use at home.

Equalizing the pressure of a tympanic effusion

Equalizing the pressure can also be a helpful home remedy for tympanic effusion. There are two maneuvers for this, but they should only be performed after medical instruction:

Valsalva overpressure maneuver: The mouth is closed for this exercise and the noses are held shut with the fingers. Breathe out against the closed nose and mouth. The resulting pressure equalization supports ventilation of the middle ear.

Politzer method: You will need a Politzer balloon for this. Hold one nostril closed and connect the other to the balloon opening. Now say a word several times that often contains the letter "k" (e.g. cockatoo). Then blow a lot of air into the balloon with your nose. This exercise also improves ventilation of the ear. Medical instruction is strongly recommended for this maneuver in particular!

Tympanic effusion surgery

In some cases, surgery is necessary to treat a tympanic effusion. One of the typical operations is the tympanic membrane incision (paracentesis). As the name suggests, a small incision is made in the eardrum, which allows the fluid to be suctioned out of the middle ear. Another common procedure used for chronic tympanic effusion is the insertion of a tympanic tube into the eardrum, which ensures better ventilation of the middle ear.

Tympanic effusion duration/tympanic effusion for how long

As a tympanic effusion often occurs as part of a common cold, it usually resolves itself within a few days to weeks. If the symptoms persist for longer than 3 weeks without being treated, chronic symptoms or consequential damage may occur.