Glue Ear Discussion

Glue ear is an appropriately descriptive term of the condition that arises from long standing fluid in the middle ear. The medical term for this condition is Adhesive Otitis. This problem most commonly affects teenagers and adults because it takes months to years for it to develop. The disease process starts in childhood with fluid in the middle ear. Over a long period of time all the air in the middle ear gets absorbed and creates a negative pressure. The fluid becomes very thick and darker in color. The negative pressure in the middle ear pulls the ear drum inward. The ear drum thins out and loses some of its strength. Over time the drum becomes adherent to the middle ear structures. The fluid may eventually resolve but the negative pressure in the middle ear continues. As the negative pressure in the middle pulls the ear drum in to the mastoid area then a condition called cholesteatoma develops. (See following chapter)

Frequently the patient will only complain of hearing loss. On physical exam the ear drum can appear darker in color. The middle ear structures (ossicles) will be more prominent and the ear drum looks like wet tissue paper draped over the middle ear bones.

This condition cannot always be corrected with treatment. The treatment usually consists of placement of middle ear ventilation ear tubes. If the drum is very adherent to the underlying structures then the tubes may not help reverse the condition. Glue ear (Adhesive Otitis) is much easier to prevent then to treat. Aggressive management of children with fluid in their ear can prevent this problem from developing.

If a child has problems with fluid in the ears, they should be evaluated periodically as they grow older. A yearly exam should be sufficient to diagnosis this problem and lead to early intervention and possible prevention.