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