The most common cause of hearing loss in childhood is fluid accumulation in the middle ear without signs of infection(otitis media with effusion). This condition is usually noticed following severe upper airway infections. Allergies, chronic or recurrent adenoid infections, can also contribute to middle ear effusion. Families should be attentive to signs such as watching TV with an increased volume and lack of response when called. Most cases resolve with regular follow-up and the treatment of underlying etiologies. However, children with chronic effusion should see an ENT doctor. Chronic otitis media with effusion does not have a medical treatment option. It can only be treated with ventilation tube insertion (with/without adenoidectomy), the most common pediatric surgery. Untreated-prolonged middle ear effusion can result in permanent conductive hearing loss in adulthood. It is also recommended to schedule a routine ENT doctor visit and hearing screening during the preschool period.