Otitis Media with Effusion is also known as Chronic Otitis Media or Glue Ear or Secretory Otitis Media or Serous Otitis Media with Effusion; it is an infection of the middle ear that affects both children and adults with children being affected more especially within the ages of 2 and 5 years. Chronic Otitis Media (Glue ear) often occurs following Acute Otitis Media (AOM) and can persist for several weeks. In secretory otitis media, recurrent acute ear infections lead to a thick glue-like exudate building up in the middle ear.
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Serous Otitis Media Epidemiology
Serous Otitis Media with Effusion (Glue ear) is the commonest cause of deafness in children as well as the commonest indication for surgery in children. It affects children in their early childhood with peaked prevalence at 2 and 5 years. About half of 3 year olds have at least one serous otitis media with effusion in a year, and in the United Kingdom, about 1 in 200 children undergoes surgery due to glue ear; 90,000 surgical operations due to glue ear are performed in England and Wales annually at an estimated cost of �30 million.
Glue Ear Causes
- Progression of acute otitis media
- Nasopharyngeal tumors especially in adults (A unilateral serous effusion in an adult is due to nasopharyngeal tumor until proven otherwise)
- Serous Otitis Media with effusion usually follows common cold and spontaneously resolves within 6 weeks
Serous Otitis Media with Effusion Symptoms and Signs (Glue ear symptoms)
- Feeling of fullness in the ear
- Tinnitus (ringing in the ear)
- Vertigo (dizziness)
- Dull retracted Tympanic Membrane
- There may be air-fluid level
- Conductive hearing loss when Whisper test, Rinne test or Weber tests is performed
- Reduced hearing may be noticed by parents or teacher of the child
- Child may be seen to be unsteady and often seen falling over
Diagnosis of Serous Otitis Media (Glue Ear Diagnosis)
- Persistent or Frequent attacks of otitis media
- Unusual multiple resolving episodes of otitis media with prolonged signs and symptoms
- Otitis media that does not resolve within 6 weeks to 3 months
- On clinical examination through Otoscopy, the tympanic membrane (eardrum) appears thickened and retracted with an absent light reflex
Serous Otitis Media with Effusion Treatment
Secretory otitis media in Children usually resolve spontaneously within 6 weeks in 50% of cases, hence the persistence of bilateral Serous Otitis media with effusion (OME) and hearing loss in a child should be confirmed over a period of 3 months before intervention is considered.
Treatment of otitis media with effusion using antibiotics may have some short-term beneficial effects but the effect does not last when compared with patients not treated with antibiotics.
Surgical treatment of Glue ear can be done through adenoidectomy or myringotomy and grommet insertion; with significant hearing loss in children especially those with language delay due to conductive hearing deafness caused by glue ear, the use of ventilation tubes (grommets) may be beneficial and the grommets are inserted through the tympanic membrane to allow the middle ear to drain, though systematic review suggests that the role of grommets in the management of glue ear is unclear.
Use of hearing aids also help in persistent Otitis media with effusion.
Serous Otitis Media with effusion Complications
- Hearing problems (conductive hearing loss)
- Occurrence in childhood may cause interference with education and normal development
Risk Factors of Serous Otitis Media with Effusion
- Cleft palate
- Down’s syndrome
- Family history