glue ear

Question 1

what is glue ear?

Answer 1

-inflammation of the middle ear accompanied by accumulation of fluid without the symptoms and signs of acute inflammation

AKA otitis media with effusion (OME) or serous otitis media (SOM)

Question 2

what increases incidence of getting glue ear?

Answer 2

More common in patients with:

• recurrent URTI
• in day care
• older siblings
• smoking household
• recurrent AOM
• prematurity
• craniofacial abnormalities/genetic abnormalities
• immunodeficiency
• allergy
• bottle feeding
• poor nutrition

more common in winter
more common in males
CHILDREN!

Question 3

how may a patient with glue ear present?

Answer 3

hearing loss

• poor school performance
• behavioural problems
• speech delay depending on age it affects them
• balance problems sometimes
• TV volume increases

Question 4

do patients with glue ear experience otalgia?

Answer 4

no

Question 5

what may be seen on otoscope of someone with glue ear?

Answer 5

• reduced TM mobility
• TM retraction
• visible ME fluid/bubbles

sometimes but less often has bulging TM (more commonly seen in AOM)

Question 6

what investigations are done for someone with suspected glue ear?

Answer 6

History

Otoscopy:

• reduced TM mobility
• TM retraction
• visible ME fluid/bubbles

Turning fork tests
Audiometry/ age appropriate hearing assessment
Tympanometry

Question 7

what would be seen in tympanometry if there was fluid in the ear?

Answer 7

line would be flat

normal on left, fluid on right

Question 8

when should a patient with OME be referred?

Answer 8

OME persistent >3 months with symptoms of deafness, speech impairment or balance impairment

Question 9

what is the treatment for OME?

Answer 9

60% resolve after 1 month
90% resolve after 3 months

recommended to watch and wait for 3 months and then review at 3 month using:

• otoscopy
• PTS
• tympanometry

<3years may do grommets (surgery)

> 3 years and first intervention may do grommets (surgery) and if they already have had grommets then an adenoidectomy is recommended

Question 10

what are complications of grommets?

Answer 10

• infection/discharge
• early extrusion
• retention
• persistent perforation
• swimming/bathing issues