Glue Ear (Otitis Media)
Another term for glue ear is “otitis media with effusion” or OME. This term is used because the “glue” is often left behind after an episode of otitis media (middle ear infection).
What causes glue ear?
There are two common causes for a glue ear –
- a poorly functioning Eustachian tube – this can be due to many causes including childhood age, immune problems and structural problems such as a cleft palate.
- a recent middle ear infection
Rarely fluid behind the middle ear accumulates because of a growth or other blockage in the back of the nose blocking the Eustachian tube opening.
Normally fluid from the middle ear drains down the Eustachian tube (Auditory tube) into the nose. If this tube is not functioning properly it can take many months for fluid to be re-absorbed by the body. During that time hearing is generally reduced and there may be a delay in speech development, learning difficulties, behavioural problems, earache and balance problems.
Most cases will settle down without medical treatment. If the glue is present for more than three months treatment is usually indicated to help resolve things more quickly.
Are there any complications of having a glue ear?
If glue ear is not treated the eardrum can gradually be pulled inwards causing thinning and occasionally a condition called a “cholesteatoma”. This occurs when skin cells become trapped within the retracted eardrum. Cholesteatomas can grow into the brain or inner ear. They require surgical removal.
What are the treatment options?
Watch and wait approach
A large portion of patients with glue ear will eventually drain the fluid without needing medical treatment. Unfortunately the length of time this will take is usually unknown and during that time hearing will be reduced. There are a number of treatments that can help to speed up recovery.
If the fluid is still present in both ears after 12 weeks or one ear after six months, surgical drainage and insertion of a grommets is indicated. Children at higher risk for speech, language or learning delay may need earlier treatment than this. Inserting grommets is a very safe procedure that will immediately return hearing to normal.
Treat any underlying allergic rhinitis
Patients with allergies, in particular allergic rhinitis (hay fever) will benefit from having these treated. This may include a topical steroid nasal spray. You can read more about allergy treatment here.
Remove large or infected adenoid tissue
Children who are snoring or have sleep apnoea, as well having the fluid drained from their ears may need to have large adenoid tissue removed which is blocking the Eustachian tubes from draining into the back of the nose or acting as a source of ongoing inflammation. You can read more about an adenoidectomy here.
There is currently no evidence that oral steroid therapy (e.g. prednisone), decongestants or anti-histamines are helpful to treat glue ear in children. You can read about potential side effects of corticosteroids (steroids) here.