To gather and analyse information from the literature concerning the management of otitis media with effusion in adults.

A review of the English-language literature from 1970 to the present.

Ventilation tubes have been the standard treatment for otitis media with effusion in adults, but examination of the results of published studies shows that they are associated with disappointing outcomes and significant complications, notably intermittent or chronic discharge, particularly in cases associated with nasopharyngeal carcinoma. Balloon dilatation of the Eustachian tube, intratympanic steroid therapy and cortical mastoidectomy appear to be possible alternatives.

A rethink of the management of otitis media with effusion in adults is needed, together with further research. For cases not associated with nasopharyngeal carcinoma, intratympanic steroid therapy appears to be a promising option.