Introduction: Otitis media with effusion (OME) is the collection of fluid in the middle ear without signs or symptoms of an acute infection. It is cured by treating the cause and restoring normal eustachian tube function. By activating jaw movement and inducing frequent swallowing, chewing gum could be effective in the conservative management of OME. Objectives: To determine the recovery rate after chewing xylitol gum for the treatment of OME, and the factors associated with OME cures in adults. Materials and methods: A non-randomized, controlled trial was conducted on 30 OME patients May 2018–December 2019. The subjects chewed 2 tabs of gum for 5–10 minutes, 3 times daily, for up to 3 months. Physical and audiometric examinations were performed at 2, 6 and 12 weeks. Results: Thirty patients were enrolled. Their mean age was 55.0 ± 20.19 years. OME resolution was found in 23/43 ears (53.49%). Myringotomy was performed in 13/43 ears (30.23%). Two factors were associated with shorter resolution times. Firstly, a patient age of 40–60 years, compared with other ages (p-value = 0.030). Secondly, an initial average air-bone gap of ≤ 20 dB, compared with larger gaps (p-value = 0.027). Conclusions: Xylitol-gum chewing did not increase the overall OME resolution rate. Nonetheless, it is still a choice for OME management as it tends to shorten the resolution time, with only minor side effects being experienced by some patients. Keywords: Otitis media with effusion, otitis media, OME, xylitol chewing gum, gum chewing, xylitol gum, gum