What is Otitus Media with Effusion?

Otitis Media with Effusion (OME) or “glue ear” is when the middle ear (inside of the ear drum) is full of fluid. OME often occurs after an upper respiratory tract infection (a cold) or an ear infection. It results in the “blocked” sensation in the ear, hearing loss and eventually delayed language development if persistent.

What causes OME?

OME often occurs after a upper respiratory tract infection or an ear infection. The lining of the ear produces fluid. This normally drains down the eustachian tube to the nasopharynx (back of the nose). The eustachian tube’s function is affected by the age of the patient (children’s eustachian is “flatter” than adults), the adenoids (these are in the nasopharynx, can be large in children and can act as a reservoir for infection) and other conditions such as cleft palate. If the fluid can’t drain down the eustachian tube, it remains in the middle ear as OME.

What happens to my child’s ear if he/she has OME?

OME or the fluid in the middle ear can fluctuate i.e. “come and go”. In most cases it will spontaneously resolve, however if the fluid is present for more than 3 months, spontaneous resolution is unlikely to occur.
OME results in hearing loss that can vary from mild to moderate. Prolonged OME and thus hearing loss, leads to delayed development of speech in children.
You should discuss with your GP a referral to an ENT surgeon.

What is the treatment of OME?

As most cases of OME spontaneously resolve, active observation is often all that is required. This could involve examination of the ear by your doctor, and potentially a hearing test and referral to an ENT surgeon if there is significant concern. However, if the OME has been present for more than 3 months, or if there are concerns regarding language development, then your ENT surgeon may recommend “grommets”.

What are “grommets”?

“Grommets” or ventilation tubes are a plastic tube inserted into the ear drum to act like a hole in the ear drum. This allows fluid behind the ear drum to drain into the ear canal. In children and most adults this requires a general anaesthetic.
Common reasons for grommets are “glue ear” or otitis media with effusion and recurrent ear infections (AOM). Usually both ears are done at the same operation. The improvement in hearing loss if present should be immediate. Grommets fall out of the ear drum by themselves between 6 -18 months after insertion. The only way to know if this has occurred is by your doctor looking in the ear.
Whilst the grommets are in place, the patient needs to avoid water in the ear canal by wearing ear plugs whilst showering and swimming. This reduced the risk of the grommets becoming infected. If the ear starts discharging with grommets in place, then the patient should be seen by their GP or ENT surgeon to start antibiotic ear drops.

Do I need a hearing test?

If you or your child has any of the following, then it is recommended to undertake a hearing test.

  • symptoms suggestive of hearing loss for a period >6 weeks i.e. trouble hearing from a
    distance or in noisy environments “class room”, TV volume turned up
  • complete hearing loss in one or both ears
  • severe dizziness i.e. vertigo (the world spinning)
  • speech delay
  • attention deficits or behavioural concerns that could be related to poor hearing If this is
    abnormal then discuss with your GP a referral to an ENT surgeon.