Glue ear is a fairly common condition in which the middle ear is filled with fluid instead of air. This condition predominantly affects one ear, and sometimes can be both ears. It is also known as otitis media with effusion, middle ear effusion or serious otitis media. Dr Anil Chowdhery, Specialist ENT from Mediclinic Al Sufouh, explains this condition in more detail.
What is glue ear?
Glue ear occurs when the middle ear is filled with a sticky glue like substance instead of air. This fluid dampens the normal vibrations leading to symptoms of diminished hearing.
How common is glue ear?
It is common in children between six months to four years of age. By 10 years of age, eight out of 10 children have had at least one episode of O.M.E. (otitis media with effusion). It is more common during winter months and in children attending daycare or living in homes where people smoke.
The main symptom associated with glue ear is diminished hearing which may range from a slight muffle to moderate loss in hearing.
Other signs and symptoms may be:
- Problems of speech and language
- Abnormal social behavior
- Tinnitus (ringing in the ear)
- Balance disorder
- Selective hearing
- Turning up the volume of TV or radio
- Episodes of mild ear pain
- Feeling of fullness in the ear.
- Problems of school performance
The major underlying cause of glue ear is because of Eustachian tube dysfunction. The Eustachian tubes are passageways that connect your throat to your middle ear and their main function is to maintain the air capacity in the middle ear cavity. If the Eustachian tubes are blocked, narrow, patulous, or malfunctioned, air from the middle ear gets absorbed and filled with serious or thick glue like fluid.
Children may develop this condition secondary to:
- Nasal allergy
- Gastroesophageal reflux
- Enlargement of adenoids and tonsils where they act as a source of infection.
- Other congenital abnormalities such as Down’s syndrome and cleft palate are contributory factors.
A thorough history and clinical examination are of utmost importance.
Otoscopic examination of the ears is done to see the condition of the ear drum.
Tympanometry is the choice of test to confirm or exclude glue ear.
Audiometry is done to assess the severity of hearing loss.
Endoscopy and x-rays are done if a source of infection is suspected. The treatment is to remove the underlying cause if possible.
Medical treatment with antibiotics, antihistamines, nasal decongestants, oral steroids may benefit in a few cases. In older children, auto-inflation with the help of “Otovent” balloon may be beneficial.
“Active observation” or “watchful waiting”: Generally the fluid will resolve with conservative management or goes away by itself with time.
Surgical management is required for children with persisting fluid in the middle ear. This would involve insertion of ventilation tubes (grommets) in the ear.
In case a source of infection such a hypertrophied adenoids or chronic tonsillitis is suspected they can be operated in the same sitting.