ENT - Glue Ear And Grommets

Question 1

Definition

Answer 1

Otitis media with effusion
The middle ear becomes full of fluid, causing a loss of hearing in that ear

Question 2

Pathophysiology

Answer 2

The Eustachian tube connects the middle ear to the back of the throat. It helps drain secretions from the middle ear. When it becomes blocked, this causes middle ear secretions (fluid) to build up in the middle ear space.

Question 3

Symptoms

Answer 3

Reduction in hearing in that ear
Aural fullness

Question 4

Diagnosis

Answer 4

Otoscopy = DULL TYMPANIC MEMBRANE with air bubbles or a VISIBLE FLUID LEVEL
- can look normal

Question 5

Management

Answer 5

Referral for audiometry
Usually resolves within 3 months without treatment
Children with co-morbidities affecting the structure of the ear, e.g. Down syndrome or cleft palate may require hearing aids or grommets

Question 6

Grommets

Answer 6

Tubes which are inserted into the tympanic membrane by an ENT surgeon.
This allows fluid from the middle ear to drain through the tympanic membrane to the ear canal.
Grommets usually fall out within a year and only 1 in 3 patients require further grommets to be inserted for persistent glue ear