Glue ear

Serous/secretory otitis media

Non-infected fluid accumulates in the middle ear due to dysfunction/obstruction of the Eustachian tube, e.g. sore throat or ear infection, or tonsillar hyperplasia.

The most common cause of hearing loss in childhood.

More common in children with Down’s syndrome or cleft lip/palate.

Symptoms

Deafness

Earache

Speech/language, delay

Behavioural problems.

Signs

• Fluid in the middle ear.
• Dull appearance of tympanic membrane with radial vessels visible – dark blue or grey colour of the tympanic membrane.
• The tympanic membrane is immobile.
• There is retraction of the ear drum.
• Rinne’s test negative; Weber’s test – sound heard loudest in the deafer ear

Management

Glue ear resolves as the child grows older—treatment is aimed at treatment of symptoms until natural resolution.

If not resolving, refer to ENT. Specialist treatment options include watchful waiting or grommet insertion.