
Introduction: Otitis media with effusion OME, which refers to the accumulation of fluid in the middle ear cavity without any signs of acute infection. The aim of study is to determine the prevalence, the risk factors and treatment. Early detection of OME leads to obtain good result within short time and help children for retaining their normal hearing. Untreated OME leads to serious social complications to the child, school, teachers and society like loss of hearing, mental retardation behavioral abnormality, speech problem, learning problem and school performance. Treatment of OME was by eradication of risk factors, medical treatment, eustachian tube rehabilitation and surgical interference. Material and methods: 1812 children examined from the first and second grade in primary schools by pneumatic otoscope. 308 children positive OME send for assessment of hearing and measuring the middle ear pressure by pure tone audiometry and tympanometry. Medical treatment was given (local steroid as Mometazone for 8 weeks, systemic antibiotic for 10 days as Amoxacillin, and systemic decongestant for 8 weeks as Montelukast, loratadine). Results: OME prevalence was 17% in Mosul city. 308 from 1812 children have had OME, those children were given medical treatment, 66% cured completely and their regaining their hearing. Only 34% resist the medical treatment and they need further treatment, follow up and surgical interferences. 21 children underwent bilateral tympanostomy with insertion of ventilation tube, 8 children underwent bilateral adenotonsillectomy with bilateral insertion of ventilation tube. Conclusion: OME is a common health problem in pre and primary school children, need early detection and early treatment with eradication of risk factors to retain their hearing for improving their school work performance