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Glue in my ear

Infect of the middle ear can lead to a condition commonly called 'glue ear'.

MY three-year-old has been having problems understanding me recently. I would call her and she would not respond. I would tell her to do some- thing, and she would just go on playing with her toys. At first I thought she was just being rude and disobedient, and I felt like disciplining her. But my mother-in-law suggested taking her to a doctor. The doctor did an ear examination and diagnosed 'glue ear'. What is glue ear?

Glue ear is a disorder where fluid builds up in the middle ear and causes impaired hearing. It is also known as secretory otitis media (otitis = ear; media= middle), otitis media with effusion, or serous otitis media. It is a very common cause of deafness in children.

People of any age can develop glue ear, but it is commonest in children under age eight (especially age two), probably because the passages in the ear grow as a child ages, becoming less easy to block.

Children who are more susceptible to glue ear are usually boys, have been exposed to tobacco smoke, were bottle-fed as a baby, has a brother or sister who had glue ear, go to a day care centre, or have repeated colds and flu.

My poor baby! I'm glad I didn't scold her or disciplined her. Where is the middle ear? Is it reachable when one pokes a finger in?

The ear is divided into three parts: the outer ear, the middle ear, and the inner ear. The outer ear is divided from the middle ear by the eardrum.

When you reach a finger in, it usually is stopped within the outer ear by the contours of the ear canal. The middle ear is the part of the ear behind the eardrum. If you pierce your eardrum with a sharp object, your middle ear can be injured.

In the middle ear, there are three tiny bones that transmit and enhance sound vibrations from the eardrum to the inner ear. They are called the malleus, incus and stapes. There is also a drainage tube called the Eustachian tube running from the middle ear to the nasopharynx, which is the area very high up in the back of your throat.

If the throat opening of the Eustachian tube gets blocked by a cold or any other disorder in that area, you will feel a "funny" pressure in your ear. That's why you can frequently swallow to "open up" this tube and equalise the pressure in your middle ear.

For a child, if there is frequent swelling from too many colds, mucous will gather in the middle ear and become thick and sticky. These three tiny bones in the middle ear will become very gummy and cannot move freely. Sounds coming in will then sound muffled.

Why is it called 'glue ear'? Is there glue in it? Is it caused by an infection?

No, there is no 'glue' per se in the middle ear for someone afflicted with it. There is actually an effusion that does not contain pus. It may either be full of mucous (hence, sticky) or serous (watery).

The term otitis media itself is a very generic term, meaning inflammation of the middle ear. It can be divided into:

1. Acute otitis media (AOM) - caused by a viral or bacterial infection in the middle ear

2. Recurrent acute otitis media (RAOM)

3. Glue ear (OME -- otitis media with effusion)

4. Chronic otitis media with effusion (COME).

Glue ear (the effusion part) can occur when the infection that causes acute otitis media resolves. As many as 45% of the children who develop AOM have a persistent effusion after one month. And multiple studies have revealed that the same pathogenic bacteria are present in glue ear as in AOM, and that there is a persistent inflammation in the middle ear mucosa that won't go away because the bacteria is still there.

How do I know if my child has developed 'glue ear'?

Children with glue ear predominantly develop hearing loss. Your child can get anything from a slightly muffled hearing in one ear to full deafness if both ears are affected.

You have to be extra careful with very young children and babies because they may not be aware there is anything wrong with their hearing. So you have to look out for these:

If your child's teacher says she has problems with talking, learning languages or speaking with her friends or adults. You may also note this on your own.

If your child is having balance problems or appears clumsy - the middle ear is also the organ for maintaining body balance.

If your child appears to have "selective hearing. There are cases of poor children being disciplined and caned for perceived disobedience or not answering when their parents or teacher call them, only to find out that they have "glue ear".

If your child has to turn up the TV or radio volume very loud, or if he keeps saying, "What?"

In the case of babies, if they are being less responsive to sounds, an ear check is warranted.

Sometimes the child can also complain of slight earache. Children who have repeated colds and flu are more likely to develop glue ear.


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