American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following statements is true regarding the management of otitis media with effusion (OME)?

1. All OME cases require immediate surgical intervention

2. Most cases resolve spontaneously without treatment

3. Antibiotics are the primary treatment option for OME

4. Most cases of OME require treatment within 2 weeks

The correct answer is: Most cases resolve spontaneously without treatment

In the context of managing otitis media with effusion (OME), the statement that most cases resolve spontaneously without treatment is accurate. OME often occurs following a respiratory infection and is characterized by fluid accumulation in the middle ear without signs of acute infection. In many instances, especially in children, the effusion may resolve on its own over time as the Eustachian tube function improves and normalizes. Clinical guidelines often suggest that watchful waiting is appropriate for cases of OME in children, particularly when there are no significant symptoms or evidence of hearing loss impacting quality of life. Intervention may only be warranted if the effusion persists for an extended period or if it leads to hearing impairment that can affect speech and language development. The other choices do not align with current medical guidelines or understanding of OME management. Immediate surgical intervention is not necessary in all cases; antibiotics are typically not effective for OME since it is not caused by bacteria; and the majority of cases do not require treatment within a specific short timeframe, as many will resolve without needing intervention.