glue ear Flashcards
what is glue ear?
-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)
what increases incidence of getting glue ear?
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!
how may a patient with glue ear present?
hearing loss
- poor school performance
- behavioural problems
- speech delay depending on age it affects them
- balance problems sometimes
- TV volume increases
do patients with glue ear experience otalgia?
no
what may be seen on otoscope of someone with glue ear?
- reduced TM mobility
- TM retraction
- visible ME fluid/bubbles
sometimes but less often has bulging TM (more commonly seen in AOM)
what investigations are done for someone with suspected glue ear?
History
Otoscopy:
- reduced TM mobility
- TM retraction
- visible ME fluid/bubbles
Turning fork tests
Audiometry/ age appropriate hearing assessment
Tympanometry
what would be seen in tympanometry if there was fluid in the ear?
line would be flat
normal on left, fluid on right
when should a patient with OME be referred?
OME persistent >3 months with symptoms of deafness, speech impairment or balance impairment
what is the treatment for OME?
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
what are complications of grommets?
- infection/discharge
- early extrusion
- retention
- persistent perforation
- swimming/bathing issues
