Serous Otitis Media Treatment

Serous Otitis Media (Fluids in the Middle ear)

Repeated ear infections are very common in children younger than 6 years of age. While many of them will outgrow their tendency to get repeated ear infections by the age of 7, some of them due to immature immune system and poor function of the eustachian tube are at increased risk of repeated ear infections and persistence of fluids in the middle ear.

Eustachian tube is a narrow tube connecting middle ear with the back of the nose. It normally equalizes middle ear pressure and helps in drainage of secretions from the middle ear into the nasopharynx. In kids, Eustachian tube is narrower and more horizontal as compared to the adults and these makes it more prone to occlusion and its dysfunction.

What is Glue ear (Fluids in the Middle ear):

• Repeated ear infections can cause the glue ear, characterized by the persistence of secretions and fluid in the middle ear.
• Fluid can stay in the middle ear for weeks to months after otitis media.
• This fluid then hampers hearing by altering movement of ear drum and ear bones.
• The hearing loss which occurs due to the glue ear, might affect your child’s understanding of language, speech development, reading ability and spelling pronunciation.

Treatment of Glue ear (Otitis media with effusion):

• For the first three months after a glue ear diagnosis, watchful waiting is advised. To enhance Eustachian tube function and fluid outflow from the middle ear, the doctor may give antihistamines or steroid nasal sprays.
• Grommet/Tympanostomy tube placement is suggested if fluids persist and cause severe hearing loss after 3 months.

Grommet / Tympanostomy tube insertion procedure:

•Grommets are small, tiny tubes less than 2 mm width made up of plastic/ silicone or other polymers, which sit in the eardrum.
• Grommets restores ventilation of the middle ear, helps in fluid drainage, and allows better eardrum vibration.
• Depending on the shape of the grommet, they can stay in for as short as a few weeks to a few years.
• Most often in kids, medium term grommet is used, which usually falls out within 9 months to 1 year.
• This is a day surgery procedure, performed under general anaesthesia.
• Child usually stays for 3-4 hours in the hospital after tube surgery and then is discharged home.
• For bathing and swimming (on the surface), no special precautions are needed. But for older kids and adults who are diving deeper than 2 meters under water, then ear plugs are recommended.
• In case of an ear infection and drainage from the ear, consult your doctor and keep your ears dry till infection is settled.

Tips to prevent Ear infections in kids:

• If your child is getting recurrent colds and flu, then vaccinate him with Flu Vaccine. Make sure your child gets Flu/Influenza vaccine every year.
• Maintain good personal hygiene, teach your child to wash hands properly as this avoids spread of germs and catching a cold or flu.
• Pneumococcal and other groups of bacteria are the most frequent cause of bacterial ear infections, vaccinate your child with the PCV7 conjugate vaccine. It is highly recommended for all children under the age of 2 to get vaccinated with PCV7 especially for the kids in Day-care.
• Avoid second-hand exposure to cigarette smoke and exposure to other kids when they are sick.