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Sticky Otitis Media: Understanding and Treating Glue Ear

Glue ear is a persistent but treatable disorder which can result in hearing loss and other problems if it is not dealt with properly. It is more formally called OME (otitis media with effusion). The name “glue ear” is, however, very apt.  The condition is marked by a build-up of a thick, sticky (and very glue-like) fluid behind the eardrum in the absence of an ear infection.

The inner ear relies on the movement of the ear drum and a few tiny bones to detect sound. As you can imagine, if this space is packed with a gluey fluid, these structures are limited in movement and the patient cannot hear particularly well.

Otitis_Media_glue_ear

What causes glue ear (OME)?

Note that OME is defined as fluid build-up without infection. In reality, there is often a relationship between glue ear and a recent infection, and the condition can even cause infections in the future.

A middle ear infection can cause a build-up of fluid in the first place, but this usually drains within a few days or weeks of the infection passing. Each ear contains a structure called the Eustachian tube, which exists primarily to drain fluid from the middle ear. If that tube becomes blocked, the fluid can remain, and begin to cause problems. The middle ear is a complex area, and there is much that can go wrong. The presence of the fluid can itself encourage the growth of bacteria, and cause subsequent inner ear infections.

So without an infection, how does that tube become blocked?

Eustachian tubes can swell due to allergies, infections of the respiratory system, or irritants like chemicals or cigarette smoke. Sudden changes in air pressure can cause the tube to collapse for a short or long period, and some reports even exist of the tubes closing due to the patient drinking while lying down.

Once one or both of the Eustachian tubes close and remain closed, glue ear is the most common result.

How doctors test for glue ear

Doctors will often check for glue ear following an ear infection, especially if there is a degree of persistent hearing loss. Typically, the ear drum is closely examined visually. Doctors or nurses look for a change in the color of the ear drum or the presence of air bubbles behind it, both of which indicate a substantial fluid build-up. They can also puff air onto the eardrum to see if it moves normally.

If fluid is detected, a more involved test called a tympanometry is usually called for, which can determine how thick the fluid behind the ear drum is. Hearing tests are also common, to determine the extent of hearing loss the patient is experiencing.

How is it treated?

Most cases of glue ear go away on their own in a few months as the Eustachian tubes eventually reopen. If not, treatment may be necessary.

There are several treatment options, and the decision of which is right for any particular patient rests with their doctor. It may be treated with antibiotics, or by surgically inserting a tube into the ear drum, to allow it to drain externally.

Once the fluid drains off, normal hearing usually returns immediately.

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