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What is “Glue ear”?

[ by Eimear Vize www.irishhealth.com]


What is glue ear?
Is glue ear painful?
Is glue ear common?
Can only children get glue ear?
Why is glue ear so common in children?
What are the symptoms?
How is glue ear diagnosed?
How is glue ear treated?
Antibiotics
Steroids
Other medications
Autoinflation
Surgery - Grommets
Will the grommets need to be put back in?
Do grommets work?
What can you do yourself?


What is glue ear?

Glue ear or otitis media with effusion (OME) is a condition in which a sticky glue-like fluid builds up behind the eardrum in the middle ear. It can interfere with a child's hearing, although this is often temporary. If hearing difficulties occur, it may also cause speech problems. Many cases get better without any treatment.

Is glue ear painful?

Glue ear does not cause acute ear pain or fever in children.

Is glue ear common?

Yes, glue ear is a common condition. Temporary childhood hearing impairment due to glue ear is widespread, with an 80% likelihood of it happening at some point between birth and seven years of age.

Can only children get glue ear?

Glue ear can develop at any age. But it's most common in:
Children under the age of seven
Children living in a household where someone smokes
Children who suffer from frequent coughs and colds
Boys
Children with a brother or sister who has also suffered from glue ear
Children who have been bottle-fed
Children who attend day care and come into contact with other children during winter or spring
Children with certain genetic conditions, such as Down's syndrome
Children with an anatomical abnormality affecting the face, such as a cleft palate.

Why is glue ear so common in children?

To work properly, the middle ear (the part of the ear concerned with hearing) needs to be full of air. The Eustachian tubes connect each ear with the back of the throat and when they open they allow air to move into the middle ear.
Children often develop colds and ear infections - and if the Eustachian tubes become infected, the walls may stick together so the air in the middle ear cannot circulate. Mucus may then be produced, which can fill the middle ear cavity.

What are the symptoms?

The most common problem is hearing loss. Sometimes the hearing loss is mild, lasts only a few weeks and gets better by itself but it may go on for many months.
If a young child's hearing is impaired by glue ear, this may delay their language and speech development and may also contribute to behavioural problems, such as lack of concentration or attention.
Perforation of the ear drum, tympanosclerosis (formation of dense connective tissue in the middle ear), ear discharge and cholesteatoma (a cystic mass of cells in the middle ear) occur more frequently in children with glue ear than in those who have not had glue ear.

How is glue ear diagnosed?

A doctor will looks inside the child's ear with an instrument called an otoscope. If the eardrum looks dull or cloudy, or fluid can be seen behind it, it is likely that glue ear is present.
A child with suspected glue ear may be referred to a hearing clinic for a hearing test and tympanometry, which measures how well the eardrum can move.

How is glue ear treated?

About half of all bouts of glue ear will get better spontaneously within three months and about 95% within one year - so doctors are often reluctant to use any form of treatment unless the glue ear persists for a long time.
Doctors usually recommend a period of 'watchful waiting' for several months during which time a child will be checked regularly to see if the glue ear is clearing up on its own.
If the glue ear doesn't go away, or if it keeps coming back and if a child has hearing loss in both ears, treatment may be recommended.
The aim of treatment for glue ear is to improve a child's hearing and wellbeing, to avoid problems with speech, behaviour and educational development and to prevent recurrent ear infections and earache.

Antibiotics

There is little good quality evidence on whether antibiotics are a useful treatment for glue ear. But the available evidence suggests that antibiotics don't help any more than placebos (inactive or 'dummy' treatments). In the long term they do not appear to improve the outcome for children with glue ear.

Steroids

Steroid drugs taken by mouth are unlikely to improve symptoms in children with glue ear and can cause slowing of growth. Steroid nose sprays do not seem to help glue ear either.

Other medications

Antihistamines and decongestants are not effective treatments for glue ear.

Autoinflation

This is a technique in which the child blows up a special small balloon using a plastic tube inserted inside their nose.
The act of blowing up the balloon helps to open the Eustachian tube, making it easier for fluid to drain away from the middle ear. The device is called Otovent.

Surgery - Grommets

A small cut is made in the eardrum and the 'glue' is drained out. A tiny ventilation tube called a grommet is placed in the hole to help keep air circulating in the middle ear and stop the 'glue' building up again. Grommets do not stay in the ears permanently - eventually they will fall out.

Will the grommets need to be put back in?

Some children need another operation once the grommets have fallen out. One study found that about half of all children with grommets need to have them reinserted within five years of the initial operation.

Do grommets work?

Grommets improve hearing for the first two years after they have been inserted but have no longer-term benefit. The possible benefits of surgery need to be weighed against the risks of problems resulting from the operation.
Insertion of grommets can cause a discharge to come out of the ears and may result in a hole (perforation) in the eardrum.
This might heal on its own, or another small operation might be needed to close it.
Sometimes the adenoids - glands at the back of the nose - are also removed at the same time that grommets are inserted.
Therefore it's usually only recommended for children who have persistent or frequent infections as well as glue ear.

What can you do yourself?

If a child has hearing problems caused by glue ear, there are things you can do to help them.
Try to talk face-to-face to them because this will make it easier for them to hear and understand you.
Reduce background noise, such as the television or radio, when you are speaking to the child.
Try to talk clearly and loudly, but don't shout.
If the child goes to school or nursery, make the teachers aware of their hearing problems. It may be helpful for the child to sit close to the teacher.
Don't let people smoke around the child because this might aggravate the glue ear.

 

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