OTITIS MEDIA WITH EFFUSION

Glue Ear
A non-suppurative otitis media

Causes

  • Blockage of the Eustachian tube by: adenoids, infection in the tube, thick mucoid fluid and tumours of the postnasal space
  • Unresolved acute otitis media
  • Viral infection of the middle ear
  • Allergy

Clinical features

  • Hearing impairment (the main feature)
    • Often fluctuant, e.g. in children: “this child hears when s/he wants to and sometimes ignores you”
  • Presence of non-purulent fluid in middle ear
  • Buzzing noise in ears/head
  • Retracted or bulging ear drum
  • Loss of usual colour of ear drum (dull eardrum)

MANAGEMENT

  • Eliminate known or predisposing causes
  • Chlorphenamine 4 mg every 12 hours for 10 days
    Child 1-2 years: 1 mg every 12 hours
    Child 2-5 years: 1 mg every 6 hours (max: 6 mg daily)
    Child 6-12 years: 2 mg every 6 hours (max: 12 mg daily)
  • Plus xylometazoline nasal drops 0.1% or ephedrine 2 drops every 8 hours for 2 weeks
    Child: Use 0.05% drops
  • Exercises: Chewing, blowing against closed nose tends to open the tube

If effusion persists >6 weeks in spite of the above:

  • Refer to ENT specialist