Otitis media with effusion may be completely asymptomatic and only detected on routine audiologic screening. The most common symptom of OME is hearing loss. While older children may complain of reduced hearing, in many cases the hearing loss is noticed by parents, a nursery nurse, or a teacher. In younger children, the only symptom may be delayed speech development or behavioral problems. Another common symptom is a "blocked" feeling in the ear, which may cause infants and young children to pull at their ears. More rarely, symptoms of earache, tinnitus, or balance disorder may be present.
Otoscopy classically reveals a dull gray- or yellow-colored tympanic membrane that has reduced mobility on pneumatic otoscopy. If the tympanic membrane is translucent, an air-fluid level or small air bubbles within the middle ear effusion may be seen
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