Serous Otitis Media 'Glue ear' - Eustachian Tube Dysfunction

Question 1

what is it?

Answer 1

• Inflammation of the middle ear accompanied by the symptoms and signs of acute inflammation with/without an accumulation of fluid
vacuum created then causes non-inflammatory effusion

Question 2

who gets it?

Answer 2

• Common in children because of eustachian tub dysfunction which can lead to poorly ventilated middle ears

Question 3

how does it present?

Answer 3

Hearing loss which impacts on speech and language skills and on educational progress
Hearing loss
Speech delay
Not otalgia
Dull tympanic membrane
Loss of light reflex
Occasionally fluid with air bubbles visible in middle ear
Associated with – adenoidal hypertrophy and nasal blockage

Question 4

how is it managed?

Answer 4

Watch and wait 90% clear up in 3 months - Review at 3 months to check how things are
Grommets if < 3 yrs, grommets and adenoidectomy if 2nd intervention
Grommet insertion into the tympanic membrane – ventilating the middle ear
Antibiotic-glucocorticoid ear drops are more effective than oral antibiotics
Adenoidectomy can be added to the procedure if there’s a strong history of complete nasal blockage or recurrent respiratory tract infections
Grommets are forced out of the tympanic membrane as it heals – usually 6month – 2 years
Developmental outcomes aren’t improved by grommets
The middle 3rd of the face grows between 7-14 so after this there tends not to be an issue