R U DEAF AWARE?

Glue Ear is a condition in which fluid accumulates in the middle ear behind the eardrum. It is the most common cause of partial deafness in children and it is estimated that one in four children are affected at some stage in their childhood. It is more common in boys with most being affected between the ages of two and five. However there are chances it may occur at a later stage, including in adulthood.

Glue Ear mainly occurs in both ears and may be difficult to detect, since it is not painful doesn't cause symptoms of an ear infection. Mostly it is due to a problem with the Eustachian tube that connects the middle ears to the back of the nose and throat.

The Eustachian tube normally plays an important role in maintaining equal air pressure between the outside and inside of the middle ear. When the tube becomes obstructed the air in the middle ear becomes absorbed, and the resulting vacuum draws fluid into the middle ear cavity from lining of ht ear (the mucosa).

Initially the fluid is thin and watery but eventually it becomes thick and tenacious, hence, the name "Glue Ear". Because the middle ear is now filled with fluid rather than air, the haring is muffled. Obstruction of the tube may be due to repeated bacterial and viral upper respiratory track infections, enlarged adenoids or nasal allergy.

It is important to note that in children the Eustachian tube is more horizontal and smaller than in adults and this is one of the reasons why Glue Ear is relatively common in children.

Children are especially prone to Glue Ear because:

• Of frequent colds and sore throats
• In children, the adenoids (lymph tissues at the back of the nose that help protect against infection) are more likely to be enlarged, blocking the opening of the Eustachian tubes.

SOME RESEARCHERS also believe children are at higher risk if exposed to cooler climes or a smoky environment. Children with genetic conditions such as Downs Syndrome may have smaller Eustachian tubes and are more susceptible to Glue Ear.

Symptoms of Glue Ears.

Glue Ear in children can sometimes go unnoticed. However, there are few warning signs, such as

• Temporary hearing loss: This is the most common symptom.
• A stuffy feeling in the ears.

Glue Ear does not cause pain the way middle ear infections (otitis media) can. Children with Glue Ear sometimes have repeated episodes of earache or middle ear infections.

Changes in behaviors include tiredness and frustration, not responding when called, falling behind at school, preference to staying in isolation.

Diagnosing Glue Ear.

If your child is showing the following symptoms and you are unclear about their condition, it is advisable to check with your nearest ENT specialist.

Often doctors rely on one or several of the following tests to make the diagnosis. They're Otoscopy, Audiometry and Tympanometry tests.

Treatment of Glue Ear.

Glue Ear does not always need treatment. Most physician prefer a conservative, or "wait and see", approach to treat the problem. There is some debate about how effective medical treatments are and the mainstay of treating children with Glue Ear is with ventilation tubes (grommets)

The decision to operate and insert a grommet in the eardrum is dependent on many factors such as the patient's age, whether there are recurrent middle ear infections, pain speech, delay learning or behavioral difficulties.

It can also depend on the appearance of the eardrum. (For instance whether there is a retraction pocket, which is a localized area of scarring that may lead to problems).

Young children with poor language development, pain or recurrent ear infection should have grommets inserted as soon as possible. Older children with fewer symptoms can be treated conservatively with regular follow-up visits in the outpatient clinic to monitor their hearing and the appearance of the ear drum.

The main objective of grommet insertion is to get rid of the fluid in the middle ear by allowing air to enter through the grommet, so temporarily by passing the problem. Normal hearing is restored once this objective is accomplished.

Grommets are available in many different shapes and sizes. On average, a grommet will stay in place between six to 12 months and will then fall out as the healing eardrum pushes it out into the ear canal. If the child redevelops Glue Ear it may be necessary to re-insert another grommet. The operation to insert a grommet usually performed as day-case surgery under general anesthesia and it is the most common ear nose throat.

An Earache Can Be A Real Pain In The Ear!

But ear aches don't have to be.

Ear aches are a common problem for many children. Some children can go through childhood with very few ear aches or none at all. Other children may stay at the doctor's office with ear aches. In learning how to combat ear aches, it is important to learn what causes ear aches. This will help parents prevent ear aches in their children.

What causes an ear ache?

The tube connecting the middle ear to the back of the nose is called the Eustachian. This tube allows fluid drain out of the middle ear. However, if that tube's lining is invaded by bacteria or viruses, the tube can become swollen and may fill up with a thick mucus. This leads to the inability of the fluid to drain normally. As bacteria grow in the fluid, pressure can build behind the ear drum and this causes pain.

Allergies, cold and other illnesses can cause the Eustachian tube to become blocked. When the adenoids become enlarged they can block the Eustachian tubes as well. These are all referred to as ear infections. They usually clear up within a week or two, but in the meantime they can be extremely painful and include fever and other symptoms. There are also times that an ear infection will last even longer than two weeks and may even become chronic. Additionally, even after the infection clears, the fluid can remain in the middle ear which can lead to even more infections and, in extreme cases, hearing loss.

What are symptoms of an ear ache?

Older children can tell you that their ear hurts. Their ear pain may also be accompanied with fever. Babies, however, and children who are too young to tell you where it hurts may cry or pull on their ear or ears. A child with an ear infection, regardless of age, may show signs of irritability, listlessness, have difficulty hearing and may not feel like eating or sleeping. This is particularly true with breastfed babies who have an ear ache. Because a breastfed baby suckles in a certain way that is different and more difficult than suckling from a bottle, this motion can irritate the baby's sore ears causing him or her to "go off his feed."

What is the treatment for ear aches?

There are several ways that a doctor may approach treating an ear ache. If the doctor suspects the infection to be bacterial, he or she may prescribe an antibiotic. Pain relievers, such as acetaminophen (Tylenol products) and ibuprofen (Advil and Motrin products) can offer some relief and reduce fever if it is present. Aspirin, however, is not recommended. Warm compresses or a heating pad applied over the ear may reduce the pain. There are also times when ear drops are prescribed.

When medications are prescribed, whether it is antibiotics or ear drops, it is imperative that they be administered as directed by the doctor. With antibiotics it is exceptionally crucial that they be given on time and that no doses are skipped.

What are some risk factors that may cause children to get ear aches?

Children who are around people who smoke are at a very high risk of getting ear infections. Additionally, if they have had previous ear infections or have a family history of ear infections can increase their risk. It is no big secret that children in day care are exposed to many more germs and viruses so this is a large risk. A child who was premature at birth or had a low birth weight may also be at a higher risk. If a child has frequent colds or other infections, takes a bottle to bed, uses a pacifier or has a nasal speech that is caused by large adenoids blocking the Eustachian tubes he or she may be more at risk of developing an ear ache. Interestingly, males tend to show a higher incidence of ear infections than females. However, knowing the risk factors and knowing if your child fits into any of these categories can be the best defense. Prevention can be the best medicine.