Earache, No Infection (Adult)

Earaches can happen without an infection. They can occur when air and fluid build up behind the eardrum. They may cause a feeling of fullness and discomfort. They may also impair hearing. This is called otitis media with effusion (OME) or serous otitis media. It means there is fluid in the middle ear. It is not the same as acute otitis media, which is often from an infection.

OME can happen when you have a cold if congestion blocks the passage that drains the middle ear. This passage is called the eustachian tube. OME may also occur with nasal allergies or after a bacterial infection in the middle ear. Other causes are:

• Trauma

• Bacterial infection of the mastoid bone (mastoiditis)

• Tumor

• Changes in pressure, such as from flying or scuba diving

The pain or discomfort may come and go. You may hear clicking or popping sounds when you chew or swallow. You may feel that your balance is off. Or you may hear ringing in the ear.

It often takes from several weeks up to 3 months for the fluid to clear on its own. Oral pain relievers and ear drops help if there is pain. Decongestants and antihistamines sometimes help. Antibiotics don't help since there is no infection. Your healthcare provider may give you a nasal spray to help reduce swelling in the nose and eustachian tube. This can allow the ear to drain.

If your OME doesn't get better after 3 months, surgery may be used to drain the fluid. A small tube may also be put in the eardrum to help with drainage.

Because the middle ear fluid can become infected, watch for signs of an infection. These may develop later. They may include increased ear pain, fever, or drainage from the ear.