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Glue ear

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Overall key points

Glue ear is a common cause of ill health in children but the absence of specific signs makes it difficult to diagnose.

Medical history, otoscopy and tympanometry are the only available diagnostic methods.

The recommended management is active monitoring for three months before referral for surgery.

Impact on quality of life is emerging as an important factor to influence referral rates.

Part 1 Background

Glue ear or otitis media with effusion (OME) is an increasingly frequent presentation in primary care and the most common reason for childhood surgery; however, there are presently no proven effective medical treatments.

OME is characterised by fluid secretion or effusion behind the eardrum, without any signs of acute inflammation and often develops after a typical acute ear infection appears to have settled.

In some children, fluid in the middle ear can also proceed into a chronic remitting and relapsing condition widely known as glue ear (when the effusions have persisted for at least six weeks and become more mucoid or glue-like).

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