GLUE EAR/ OTITIS MEDIA

DEFINITION

The accumulation and persistence of watery or mucoid fluid in the middle ear (also known as otitis media with effusion, or OME).

MIDDLE EAR FUNCTION

The middle ear is an air-filled space separated from the outer ear canal by a membrane (eardrum) and containing three little bones, which conduct sound vibrations through to the inner ear.  The healthy middle ear is ventilated via the Eustachian tube (from the back of the nose) whenever we yawn or swallow, such that middle ear air pressure is normally the same as the surrounding atmosphere.               

WHAT CAUSES GLUE EAR?

If the Eustachian tube is not functioning properly, the air in the middle ear is not regularly replenished.  The air pressure drops within the middle ear, and fluid exudes into the resultant vacuum from the mucus membranes lining the middle ear space.

Eustachian tube function may be immature in babies and may be compromised in older children by nasal congestion (from winter colds or nasal allergy).  A large adenoid pad (tonsil-like tissue at the back of the nose) may physically block the Eustachian tubes.

As children get bigger the Eustachian tubes work more efficiently and these factors become less critical.  Glue ear is much less common in children over the age of eight years.

For reasons not well understood, the problem may persist for longer in some children. Some congenital conditions may also result in troublesome, persistent glue ear, which responds poorly to treatment.

THE EFFECTS OF GLUE EAR

Glue ear may occur in the context of frequent acute (painful) ear infections, but may also develop ‘silently’ with no signs of discomfort.

In either scenario, the child suffers hearing loss for as long as the condition persists.  In long-standing, unrecognised glue ear the eardrum may become weakened and in‑drawn (or retracted), posing the risk of more significant middle ear damage.

DIAGNOSIS

Screening hearing tests are invaluable in young children.  Trained medical staff will recognise the appearance of glue ear when examining the child.

TREATMENT

A conservative ‘wait and see’ approach may be adopted for up to 3 months (though frequent, painful ear infections may make the situation more urgent). During this time regular nose-blowing is encouraged and specific treatment may be directed at suspected nasal allergy.

Ventilation tubes (grommets) may be recommended if the problem persists.  Grommets are inserted into the eardrums under a general anaesthetic: the surgeon may recommend the simultaneous removal of large adenoids or the irrigation of infected sinuses to improve nasal function.

YOUR CONSULTATION

If you think that you or your child suffers from glue ear (otitis media with effusion), and would like help, please book an appointment by calling 031 201 3118.

At your consultation, best ENT practice guidelines will be followed.

A detailed history of your problem will be taken.

This will be followed by a complete examination of the outer and middle ears, and of the nasal passages, including nasal endoscopy, to exclude significant rhinitis, sinusitis and adenoid hypertrophy.

An audiogram (hearing test) may be requested, and the appropriate treatment prescribed according to best ENT specialist practice guidelines.