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Glue Ear

Glue Ear is a condition in which fluid accumulates in the middle ear behind the eardrum. It is the most common cause of partial deafness in children and it is estimated that one in four children are affected at some stage in their childhood. It is more common in boys with most being affected between the ages of two and five. However there are chances it may occur at a later stage, including in adulthood.

Glue Ear mainly occurs in both ears and may be difficult to detect, since it is not painful doesn’t cause symptoms of an ear infection. Mostly it is due to a problem with the Eustachian tube that connects the middle ears to the back of the nose and throat.

The Eustachian tube normally plays an important role in maintaining equal air pressure between the outside and inside of the middle ear. When the tube becomes obstructed the air in the middle ear becomes absorbed, and the resulting vacuum draws fluid into the middle ear cavity from lining of ht ear (the mucosa)

Initially the fluid is thin and watery but eventually it becomes thick and tenacious, hence, the name “Glue Ear”. Because the middle ear is now filled with fluid rather than air, the haring is muffled. Obstruction of the tube may be due to repeated bacterial and viral upper respiratory track infections, enlarged adenoids or nasal allergy.

It is important to note that in children the Eustachian tube is more horizontal and smaller than in adults and this is one of the reasons why Glue Ear is relatively common in children.

Children are especially prone to Glue Ear because.

 

Of frequent colds and sore throats

 

In children, the adenoids (lymph tissues at the back of the nose that help protec against infection) are more likely to be enlarged, blocking the opening of the Eustachian tubes.

 

SOME RESEARCHERS also believe children are at higher risk if exposed to cooler climes or a smoky environment. Children with genetic conditions such as Downs Syndrome may have smaller Eustachian tubes and are more susceptible to Glue Ear.

Symptoms of Glue Ear.

Glue Ear in children can sometimes go unnoticed. However, there are few warning signs, such as

 

Temporary hearing loss: This is the most common symptom.

 

A stuffy feeling in the ears. Glue Ear does not cause pain the way middle ear infections (otitis media) can. Children with Glue Ear sometimes have repeated episodes of earache or middle ear infections.

 

Changes in behaviors include tiredness and frustration, not responding when called, falling behind at school, preference to staying in isolation.

Diagnosing Glue Ear.

If your child is showing the following symptoms and you are unclear about their condition, it is advisable to check with your nearest ENT specialist.

Often doctors rely on one or several of the following tests to make the diagnosis. They’re Otoscopy, Audiometry and Tympanometry tests.

Treatment of Glue Ear.

Glue Ear does not always need treatment. Most physician prefer a conservative, or “wait and see”, approach to treat the problem.

There is some debate about how effective medical treatments are and the mainstay of treating children with Glue Ear is with ventilation tubes (grommets)

The decision to operate and insert a grommet in the eardrum is dependent on many factors such as the patient’s age, whether there are recurrent middle ear infections, pain speech, delay learning or behavioral difficulties.

It can also depend on the appearance of the eardrum. (For instance whether there is a retraction pocket, which is a localized area of scarring that may lead to problem)

Young children with poor language development, pain or recurrent ear infection should have grommets inserted as soon as possible. Older children with fewer symptoms can be treated conservatively with regular follow-up visits in the outpatient clinic to monitor their hearing and the appearance of the ear drum

The main objective of grommet insertion is to get rid of the fluid in the middle ear by allowing air to enter through the grommet, so temporarily by passing the problem. Normal hearing is restored once this objective is accomplished.

 

Grommets are available in many different shapes and sizes. On average, a grommet will stay in place between six to 12 months and will then fall out as the healing eardrum pushes it out into the ear canal. If the child redevelops Glue Ear it may be necessary to re-insert another grommet. The operation to insert a grommet s usually performed as day-case surgery under general anesthesia and it is the most common ear nose surgery.

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Middle Ear Infection- Causes, Symptoms and Diagnosis

Normally the eardrum is airtight and watertight. To keep pressure inside and outside the eardrum equal, we have natural "drainage" tubes (the Eustachian tubes) that connect the middle ears (the space behind the eardrum) to the back of the nose and throat. Our ears always produce small amounts of fluid; this normally drains down the Eustachian tubes, and is usually in such a small amount that we don't even notice it in the throat

Ear infections are one of the most common reasons parents take their children to the doctor. While there are different types of ear infections, the most common is called otitis media, which means an inflammation and infection of the middle ear. The middle ear is located just behind the eardrum.

Otitis media is inflammation of the middle ear. "Otitis" means inflammation of the ear, and "media" means middle. This inflammation often begins with infections that cause sore throats, colds or other respiratory problems, and spreads to the middle ear. These can be caused by viruses or bacteria, and can be acute or chronic.

The middle ear also contains the eustachian (pronounced you-STAY-shun or you-STAY-shee-un) tube, which connects the middle ear to the pharynx (pronounced FAHR-inks). The pharynx is a passageway behind the nose through which air passes into the lungs. The eustachian tube helps maintain an equal air pressure between the middle ear and the outside world.

Symptoms

In Otitis Media, inflammation occurs on that portion of the ear which is directly behind the ear drum. There is discharge of pus into the outer ear. As the condition progresses, the inner ear beomes seriously affected and hearing considerably impaired. There is suppression of middle ear through a perforation of drum. In case of children, supression may start slowly without any reason. If the suppression is left unattended it may result in deafness.

Causes

Bacteria and viruses can cause otitis media. Bacteria such as Streptococcus pneumoniae (pneumococcus), nontypable Hemophilus influenzae and Moraxella account for about 85% of cases of acute otitis media. Viruses account for the remaining 15%. Affected infants under six weeks of age tend to have infections from a variety of different bacteria in the middle ear.

Ear infections are common in infants and children in part because their eustachian tubes become clogged easily. For each ear, a eustachian tube runs from the middle ear to the back of the throat. Its purpose is to drain fluid and bacteria that normally occurs in the middle ear. If the eustachian tube becomes blocked, fluid can build up and become infected.

Diagnosis

In most cases, if someone is suffering from a cold or sore throat that suddenly gets worse, with ear pain and a fever, then the diagnosis is likely to be otitis media. It is still wise to see a doctor, as he will look into the ear with a special torch known as an otoscope, enabling him/her to see clearly if there is inflammation and/or infection.

There's no single best approach for treating all middle ear infections. In deciding how to manage your child's ear infection, a doctor will consider many factors, including:

The type and severity of the ear infection

How often your child has ear infections

How long this infection has lasted

How old your child is



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