Glue ear (otitis media with effusion)
What is glue ear?
Glue ear, also called ear fluid or otitis media with effusion (OME), is a build-up of mucus or fluid behind the middle ear. It is a common childhood condition and affects majority of children at least once by the 5 years of age.
What is the difference between glue ear and ear infection?
Ear infection, also called acute otitis media (AOM), occurs when bacteria or viruses enter the middle ear and cause ear pain, fever, bulging of the ear drum and active inflammation.
Despite that both glue ear and ear infection have fluid in the middle ear, glue ear doesn’t have an active infection nor does it have pain.
Is my child at risk of having glue ear?
The risk factors in our population include:
- Age less than 5 years
- Ear infection (Acute Otitis Media)
- Frequent colds
- Day care attendance
- Smoker in the house
- Enlargement of adenoids
- Other conditions like Down’s syndrome and Cleft Palate
What are the symptoms of glue ear?
The most common symptoms are:
- Mild hearing loss
- Imbalance or clumsiness
- Poor school performance
- Fullness of the ear
- Disturbed sleep
- Emotional distress
- Delayed speech
Will my child’s hearing be affected by glue ear?
Hearing difficulty might occur if your child is in a group or with background noise. However, this effect is small and goes away once the fluid is clears up.
How is glue ear diagnosed?
Glue ear is detected via medical history, physical examination and an ear examination using an otoscope. A test, called a tympanometry, may be requested to measure movement of the ear drum. Hearing tests are ordered if the fluid persists for more than 3 months or the child is at risk of speech and language delay.
What are the options in treating glue ear?
- Watchful waiting (not taking medical action) is the first treatment option. The fluid often clears up by its own within 3 months (90 days) in the majority of children. Follow up with your ENT specialist is essential to make sure the fluid has all cleared up.
- Surgery to insert grommets (ear tubes) if your child still has ear fluid after 3 months, repeated long periods of OME, hearing loss, or other related health problems. Grommets are placed into the eardrum to allow air into the middle ear space and prevent constant middle ear fluid.
- Depending on the child, removal of the adenoids (adenoidectomy) might be considered in the same sitting as insertion of grommets.
- Studies have shown mixed benefit in use of antibiotics, oral and nasal steroids, oral and nasal decongestants or drugs to reduce gastric reflux in the treatment of glue ear.
- No benefit has been shown in use of alternative medicine, special diets, herbal medication or complementary medicine.
How Can I Make My Child More Comfortable?
You can help your child by keeping him or her away from second-hand smoke, especially in closed spaces such as a car or house. If your child is more than 1 year old and uses a pacifier, stop using the pacifier during the day.
Your child may have some minor hearing problems while the fluid is still present. Help your child to understand you better by standing or sitting close when you speak so that he or she can see your face. Remember to speak clearly. If your child does not understand you, repeat yourself and be patient. Not hearing well is frustrating for your child too!
Can glue ear turn into an ear infection
Glue ear cannot directly turn into an infection; however, the risk of getting an ear infection increases during a cold because the fluid makes it easier for bacteria and viruses to travel and multiply.
Can my child travel on an airplane with glue ear?
There is usually no problem if the ear is completely full of fluid or mucus. When the ear is partially full with fluid or the fluid is mixed with air, then it can be painful on landing. The ENT surgeon might measure the amount of fluid using a tympanogram. Strategies like constant swallowing or chewing a piece of gum while landing are helpful in alleviating any discomfort while the plane is landing.
The content on the Nairobi ENT website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions.
- Kiama AM. Prevalence of Otitis Media with effusion in children with obstructive adenoid disease compared with normal controls in Kenyatta National Hospital. (Unpublished data). 2014.
- Mugweneza A. Risk factors for otitis media with effusion in children at Kenyatta National Hospital. (Unpublished data). 2015.
- Rosenfeld, Richard M., et al. “Clinical practice guideline: otitis media with effusion (update).” Otolaryngology–Head and Neck Surgery1_suppl (2016): S1-S41.