Otitis Media with Effusion (Glue Ear)

Question 1

What is this a presentation of?
Parent noticed hearing impairment in young child, poor listening and speech, developmental delay, poor behaviour, recurrent infections, balance problems.

Answer 1

Otitis media with effusion (glue ear)

Question 2

What are the risk factors for otitis media with effusion (glue ear)?

Answer 2

1. URTI, winter
2. Atopy, passive smoking
3. Oversized adenoids
4. Boys
5. Down’s syndrome, cleft palate

Question 3

What is this examination finding typical of?

Fluid level/bubbles/retracted or bulging drum of tympanic membrane. May look dull/grey or yellow.

Answer 3

Otitis media with effusion (glue ear)

Question 4

How is otitis media with effusion (glue ear) investigated, and what is the finding of the investigation?

Answer 4

1. Refer for formal assessment of hearing.

2. Conductive deafness

Question 5

What is the management of otitis media with effusion (glue ear)?

Answer 5

1. Usually mild, resolves spontaneously.
2. Observe for 3 months if bilateral, reassess with hearing test.
3. If persistent, and unaffected ear has hearing loss - insert grommet.

Question 6

What is a grommet?

Answer 6

Tympanostomy tube - wise to use earplug if swimming, usually extrude after 3-12 months (recheck hearing)