clinical features of glue ear

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The highest incidence of glue ear is between the ages 2 and 5.

The patient may present with a variety of symptoms:

  • hearing impairment
    • may be the only symptom (often not identified in infants and young children) (1)
    • may present as mishearing, difficulty when communicating in a group, requesting to repeat things, listening to television or audio devices at excessively high sound levels (2,3)
    • significant hearing loss may be observed in OME which is bilateral and has lasted for more than one month (4)
  • speech or language development delay
  • behavioural problems
    • lack of concentration or attention
    • being withdrawn
    • ear rubbing, irritability or sleep disturbances in infants
  • learning difficulties at school
  • recurrent ear infections or mild intermittent ear pain, fullness or “popping”
  • history of recurrent upper respiratory tract infection or frequent nasal obstruction
  • less frequently - balance difficulties, unexplained clumsiness, tinnitus and intolerance of loud noises (2,3)
  • via screening

Signs include:

  • fluid in the middle ear
  • dull appearance of tympanic membrane with radial vessels visible - dark blue or grey colour of the tympanic membrane
  • the tympanic membrane is immobile
  • there is retraction of the ear drum
  • Rinne's test negative; Weber's test - sound heard loudest in the deafer ear.
  • there may be a flat curve with impedance audiometry

Reference:

Last reviewed 01/2018

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