Jubilee Hospital,Trivandrum.
Hearing Loss in Children-Part4
Glue Ear (OME)
What Is Glue Ear
Glue ear is a painless condition in which thick, sticky fluid collects behind the eardrum. The fluid blocks the middle part of the ear and can cause impaired hearing.
It results in a hearing loss with an average of 30-40 decibels (dB). If glue ear is not given proper treatment, it will lead to delayed speech in young children, and affect a child’s behavior and educational progress. Sometimes, it may cause permanent damage to hearing.
The thick yellowish white fluid behind the eardrum looks like glue, hence the name glue ear. It is also known as chronic otitis media with effusion, or middle ear effusion or secretory otitis media.
What causes it?
Glue ear occurs when there is a problem in the Eustachian tube. This tube connects the middle ear to back of the throat and nose. The middle ear is filled with air that travels through the Eustachian tube to the back of the nose. The tube helps the middle ear to drain the fluids.
When there is an ear infection, the Eustachian tube swells. This swelling blocks the middle ear drainage. As a result, there will not be a proper airflow from the tube to the nose. When this happens, the middle ear builds up pressure, which leads to the formation of a thick and glue-like fluid. This fluid fills the middle ear which leads to partial deafness.
In the case of babies, the Eustachian tube is shorter and straighter that in adults. This makes them less efficient in draining the ear, which results in blockage. Children, when colds and sore throats in children can infect the tube will lead to glue ear.
Adenoid
In some children, the adenoids are likely to be increased in size. This will block the opening of the Eustachian tube, which in turn leads to OME.
Detecting Hearing loss
Children suffering from glue ear will have muffled hearing. It will not be complete deafness. Detecting hearing loss in small children is not easy since they will not be able to converse properly. Such children may not pay attention to others. School children may be poor at studies. They will want to watch TV with the sound volume high. In the case of babies, there will be a delay in speech. The early stages of glue ear will be pain free. Children suffering from this disease will be clumsier than normal. If not detected in time, it will lead to impaired hearing.
Audiogram and Tympanogram
Audiogram is the measurement of hearing and Tympanogram is the pressure and movement of the ear drum. Audiogram may be difficult to perform in young kids.
Treatment for Glue Ear
There are various treatments for curing glue ear. It can be done either by intake of medicines or by minor surgery.
Treatment by Medications
Antibiotics: Antibiotic therapy has been proved effective for children suffering from glue ear. Due to the infection, which leads to glue ear, the child will suffer from pain. Antibiotics are the best-prescribed medicines for glue ear. If the infection is present and if it is not treated on time, child will end up with a hearing loss.
Antihistamines and a short course of steroid may help resolve glue in some cases.
Treatment by Surgery
Myringotomy: Myringotomy is a method, which helps in draining the fluid from the middle ear. A small opening is made on the eardrum. This incision helps in removing the fluid from the middle ear. It takes about a week’s time for the eardrum to heal.
Myringotomy is also done to insert ear tubes in the eardrums. This helps in allowing free flow of air between the Eustachian tube and the nose and throat. It also helps in further drainage of fluids.
This is a very small procedure done under a short anesthetic. The child can go home after couple hours.
Grommets: Ear tubes are also called tympanostomy tubes, or grommets. In ear tube surgery, the surgeon will make an incision in the eardrum to remove the excess fluid from the middle ear. A small plastic tube will be inserted through this incision. The operation is done through the eardrum externally without any cut on the child’s skin.
Once the ear tube is placed, the child’s hearing capability will be back to normal. The tube stays in the ear for 6-9 months. It will fall out on its own once the eardrum closes.
The child should have earplugs or cotton coated with petroleum jelly to avoid the water getting inside the ear especially going for swimming.
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