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The most common symptom of Otitis Media with Effusion (OME) in adults is mild to moderate conductive hearing loss due to fluid buildup in the middle ear, which prevents normal sound conduction.

Why Not the Other Options?
• B - Aural Fullness → Common but not as frequent as hearing loss.
• C - Pulsating Tinnitus → Rare; more associated with vascular issues (e.g., glomus tumors).
• D - Ear Pain → Not a primary symptom; more characteristic of Acute Otitis Media (AOM) rather than OME, which is usually painless.

Key takeaway: Hearing loss is the most frequent symptom, while aural fullness is also common but secondary.