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Medical Specialties

At the Center for Neurosciences, we work together across specialties to provide the best, most comprehensive approach to treatment.

Otitis Media with Effusion (Fluid Behind the Eardrum)

Otitis media with effusion (OME) is the buildup of thin (serous) or thick (mucoid) fluid in the middle ear space (under the ear drum) that occurs after an acute, bacterial ear infection or due to anatomic/functional blockage of the Eustachian tube. OME may occur at any age but is most common in young children. Symptoms of OME include ear fullness/pressure, mild-moderate hearing loss, heightened awareness of body sounds like your pulse, and autophony, the sense of hearing your own voice louder than normal in the affected ear.

Most internists and pediatricians observe rather than treat OME until the fluid persists for several months. This is especially true in children. Antibiotics are generally not helpful, and nasal decongestants/steroid sprays can be trialed with variable success. If fluid in the middle ear persists for several months without resolution, patients are typically referred to E&H for further management.

Surgical options for treatment of OME include myringotomy (incision in the ear drum that typically closes within five days) or myringotomy with pressure equalization (PE) tube placement (tubes generally last for 6 – 18 months). Those requiring a second or 3rd set of PE tubes may also need an adenoidectomy (performed in the operating room) at the same time in order to improve Eustachian tube function. The decision to undergo surgical treatment is based on the self-perceived or parent-perceived disability caused by OME for each individual patient. Objective evidence of persistent hearing loss from the effusion is also an indication for treatment.

Adults with new-onset, single ear OME should have a fiberoptic examination of nasopharynx (back of the nose) to make sure that no mass lesions there are physically obstructing the nasal opening of the Eustachian tube. This is an in-office procedure that can be performed at the initial patient consultation. While rare, nasopharyngeal lesions require biopsy and further medical/surgical management based on pathology results.

Why Choose Us

  • Dr. Abraham Jacob, Medical Director for Ear & Hearing (E&H) at the Center for Neurosciences (CNS), is fellowship trained in Otology, Neurotology, and Cranial Base Surgery. He is the first and most experienced Neurotologist in Tucson.
  • Dr. Jacob was a founding member of the University of Arizona (UA) Department of Otolaryngology prior to his departure and transition to CNS. At UA, he was Vice Chair of ENT and held the rank of full Professor with Tenure. He has an international reputation as an expert for treating ear diseases.
  • Dr. Jacob transitioned his practice to the Center for Neurosciences in early 2017 as he felt that the new environment helped him to optimize delivery of personalized ear and lateral skull base care.
  • Dr. Abraham Jacob performs all procedures required for treatment of both routine and complex ear diseases. This includes myringotomy +/- placement of PE tubes as well as adenoidectomy. When required, Dr. Jacob is one of the few physicians in Tucson skilled in mastoid surgery.