Ucho kleiste (otitis media z efuzją)

Ucho kleiste (otitis media z efuzją)
Leczenie

Otitis media z efuzją (ucho kleiste) charakteryzuje się obecnością lepkościowego płynu w uchu środkowym, prowadząc do niedosłuchu, głównie u dzieci. W około 50% przypadków dochodzi do samoistnego ustąpienia w ciągu 3 miesięcy, co uzasadnia początkową strategię aktywnej obserwacji. Autoinflacja za pomocą urządzenia Otovent, stosowana 2-3 razy dziennie u dzieci powyżej 4 roku życia, wykazuje skuteczność w normalizacji ciśnienia w uchu środkowym u około 50% pacjentów po 3 miesiącach terapii. Farmakoterapia, w tym antybiotyki, leki antyhistaminowe, dekongesty i sterydy, nie jest zalecana jako leczenie pierwszego rzutu ze względu na ograniczoną skuteczność. S-karboksymetylocysteina może zmniejszać potrzebę interwencji chirurgicznej, redukując liczbę operacji wszczepienia drenów u dzieci. Wytyczne NICE i NHS odradzają stosowanie wielu leków i terapii alternatywnych.

Ucho kleiste (otitis media z efuzją) – metody leczenia

Obserwacja i samoistne ustępowanie

Metody nieinwazyjne leczenia ucha kleistego

Autoinflacja – metoda balonikowa
Farmakoterapia

Metody inwazyjne leczenia ucha kleistego

Dreny wentylacyjne (grommety)
Adenoidektomia

Aparaty słuchowe w leczeniu ucha kleistego
Strategie wspomagające leczenie ucha kleistego
Leczenie ucha kleistego u dorosłych
Efektywność leczenia ucha kleistego
Wskazania do różnych metod leczenia
Zalecenia przy wyborze terapii ucha kleistego

Kolejne rozdziały

Ucho kleiste (otitis media z efuzją) – metody leczenia

Ucho kleiste (otitis media z efuzją) to stan, w którym w uchu środkowym gromadzi się płyn przypominający klej, co prowadzi do niedosłuchu. Choroba ta najczęściej dotyka dzieci, ale może występować również u dorosłych. Leczenie ucha kleistego zależy od nasilenia objawów, czasu trwania schorzenia oraz wpływu na jakość życia pacjenta.¹²

Obserwacja i samoistne ustępowanie

Większość przypadków ucha kleistego ustępuje samoistnie, bez konieczności interwencji medycznej. Około 50% przypadków rozwiązuje się spontanicznie bez leczenia w ciągu kilku tygodni do 3 miesięcy.³⁴ Zgodnie z wytycznymi, lekarze zazwyczaj zalecają okres „aktywnej obserwacji” lub „wyczekiwania”, trwający około 3 miesięcy, podczas którego monitoruje się stan uszu dziecka.⁵⁶

U większości dzieci epizody ucha kleistego ustępują samoistnie w ciągu 3 miesięcy. Jeśli stan ten nie ustępuje po tym czasie, a u dziecka występuje niedosłuch, który wpływa na rozwój mowy lub funkcjonowanie w szkole, rozważane są dodatkowe opcje terapeutyczne.⁷⁸

Metody nieinwazyjne leczenia ucha kleistego

Autoinflacja – metoda balonikowa

Autoinflacja to technika nieinwazyjna, która może pomóc w odprowadzeniu płynu z ucha środkowego. Polega na zwiększeniu ciśnienia wewnątrz nosa, co pomaga otworzyć trąbkę słuchową i umożliwić odprowadzenie płynu.⁹¹⁰

Najczęściej stosowanym urządzeniem do autoinflacji jest Otovent, który składa się ze specjalnego balonika nadmuchiwanego przez nos. Dziecko używa go, zakrywając jedno nozdrze i dmuchając przez drugie, co wykonuje technikę Valsalvy i otwiera trąbkę słuchową. Ta metoda powinna być stosowana 2-3 razy dziennie.¹¹¹²¹³

Badania kliniczne wykazały, że autoinflacja może być skuteczna w leczeniu ucha kleistego u dzieci powyżej 4 roku życia. W jednym z badań po 3 miesiącach stosowania Otoventu u około 50% dzieci nastąpiła normalizacja ciśnienia w uchu środkowym, w porównaniu do 38% w grupie kontrolnej.¹⁴¹⁵

Otovent jest dostępny bez recepty w aptekach lub online. Jest to jedyna klinicznie udowodniona niefarmakologiczna i niechirurgiczna metoda leczenia ucha kleistego.¹⁶¹⁷

Farmakoterapia

Stosowanie leków w terapii ucha kleistego ma ograniczoną skuteczność i nie jest powszechnie zalecane jako leczenie pierwszego rzutu.¹⁸

Antybiotyki – są przepisywane tylko w przypadku współistniejącego zakażenia ucha. Mogą pomóc w zwalczeniu infekcji, ale mają jedynie niewielki i tymczasowy wpływ na usunięcie płynu z ucha środkowego.¹⁹²⁰²¹
Leki antyhistaminowe, dekongesty i sterydy – ogólnie nie są zalecane w leczeniu ucha kleistego ze względu na brak dowodów na ich skuteczność.²²²³
S-karboksymetylocysteina – zgodnie z badaniami systematycznymi, lek ten może być skuteczny w leczeniu ucha kleistego u dzieci. Badania wykazały, że na każde 5-6 dzieci leczonych tym lekiem przez 1-3 miesiące, jedno dziecko unika operacji wszczepienia drenów, której w przeciwnym razie by wymagało.²⁴²⁵

Należy podkreślić, że wytyczne NICE (National Institute for Health and Care Excellence) oraz NHS nie zalecają stosowania: antybiotyków, leków antyhistaminowych miejscowych lub ogólnoustrojowych, miejscowych lub ogólnoustrojowych leków zmniejszających przekrwienie, miejscowych lub ogólnoustrojowych steroidów, homeopatii, osteopatii czaszkowej, akupunktury, modyfikacji diety (w tym probiotyków), immunostymulantów i masażu.²⁶²⁷

Metody inwazyjne leczenia ucha kleistego

Dreny wentylacyjne (grommety)

Gdy ucho kleiste utrzymuje się przez ponad 3 miesiące i powoduje znaczące problemy ze słuchem lub rozwój mowy jest zaburzony, często zaleca się zabieg wszczepienia drenów wentylacyjnych, zwanych również szpuntami lub drenami.²⁸²⁹

Zabieg polega na wykonaniu małego nacięcia w błonie bębenkowej (myringotomia) i wprowadzeniu małych plastikowych lub metalowych rurek do ucha. Procedura ta:

Umożliwia odprowadzenie płynu z ucha środkowego
Pozwala na wentylację ucha środkowego poprzez wyrównanie ciśnienia
Poprawia słuch natychmiast po zabiegu
Jest wykonywana w znieczuleniu ogólnym, jako procedura jednodniowa
Trwa około 10-15 minut³⁰³¹³²

Dreny wentylacyjne zazwyczaj wypadają samoistnie w ciągu 6-12 miesięcy. Około 70% dzieci, które przeszły zabieg wszczepienia drenów, ma wyleczone ucho kleiste do czasu wypadnięcia drenu. U około 1/3 przypadków dreny mogą wypaść przed całkowitym ustąpieniem choroby, co może wymagać ponownego zabiegu.³³³⁴³⁵

Możliwe powikłania po wszczepieniu drenów wentylacyjnych to:

Infekcje ucha (wyciek z ucha)
Tympanoskleroźa (zwapnienie błony bębenkowej)
W rzadkich przypadkach – trwała perforacja błony bębenkowej po wypadnięciu drenu³⁶³⁷

Adenoidektomia

Adenoidektomia to zabieg polegający na usunięciu migdałka gardłowego (adenoidów), który może być wykonywany jako uzupełnienie wszczepienia drenów wentylacyjnych lub jako samodzielny zabieg.³⁸³⁹

Zabieg ten jest zalecany, gdy:

Powiększone adenoidy przyczyniają się do blokady trąbki słuchowej
Dziecko ma częste infekcje górnych dróg oddechowych
Występują nawracające epizody ucha kleistego
Dziecko ma 4 lata lub więcej⁴⁰⁴¹⁴²

Badania wykazują, że adenoidektomia połączona z wszczepieniem drenów wentylacyjnych może zmniejszyć prawdopodobieństwo nawrotu ucha kleistego po wypadnięciu drenów. Usunięcie adenoidów pomaga w lepszym funkcjonowaniu trąbki słuchowej i zapobiega infekcjom.⁴³⁴⁴

Aparaty słuchowe w leczeniu ucha kleistego

Aparaty słuchowe są alternatywną metodą leczenia ucha kleistego, szczególnie gdy:

Pacjent nie może być poddany operacji ze względu na inne problemy zdrowotne
Poprzednie zabiegi wszczepienia drenów nie były skuteczne
Rodzice lub pacjent preferują niechirurgiczne metody leczenia⁴⁵⁴⁶⁴⁷

Aparaty słuchowe nie leczą przyczyny ucha kleistego, ale pomagają w kompensacji niedosłuchu do czasu samoistnego ustąpienia choroby. Najczęściej stosowane są:

Konwencjonalne aparaty słuchowe – wzmacniają dźwięki, aby poprawić słyszenie
Aparaty słuchowe na przewodnictwo kostne – przenoszą dźwięki przez kość czaszki bezpośrednio do ucha wewnętrznego, omijając wypełnione płynem ucho środkowe⁴⁸⁴⁹⁵⁰

Strategie wspomagające leczenie ucha kleistego

Oprócz głównych metod leczenia, warto wdrożyć strategie wspomagające, które mogą pomóc w komunikacji z dzieckiem z uchem kleistym:

Stać twarzą w twarz z dzieckiem podczas mówienia
Mówić wyraźnie i nieco głośniej niż zwykle
Wyłączać konkurencyjne bodźce dźwiękowe, takie jak telewizor czy radio
Zachęcać do codziennego czytania, co pomaga w rozwoju języka⁵¹⁵²

W przypadku dzieci z opóźnieniami w rozwoju mowy spowodowanymi uchem kleistym, często zalecana jest terapia logopedyczna, która może pomóc w nadrabianiu zaległości w rozwoju mowy i języka.⁵³⁵⁴

Leczenie ucha kleistego u dorosłych

Ucho kleiste u dorosłych jest rzadsze niż u dzieci, ale leczenie opiera się na podobnych zasadach:

Obserwacja i okres wyczekiwania przez około 3 miesiące
Metody autoinflacji, takie jak Otovent
W przypadku alergii lub stanu zapalnego – sterydy donosowe
W przypadkach utrzymującego się ucha kleistego – wszczepienie drenów wentylacyjnych⁵⁵⁵⁶⁵⁷

U dorosłych częściej bada się przyczyny ucha kleistego, gdyż może być ono objawem innych poważniejszych stanów. Jeśli objawy nie ustępują, zaleca się konsultację z laryngologiem.⁵⁸

Efektywność leczenia ucha kleistego

Skuteczność leczenia ucha kleistego zależy od metody, wieku pacjenta oraz przyczyny schorzenia:

Obserwacja i samoistne ustępowanie – około 90% przypadków ustępuje samoistnie w ciągu roku bez interwencji.
Autoinflacja – badania wykazują skuteczność u 50% pacjentów po 3 miesiącach stosowania.
Dreny wentylacyjne – zapewniają natychmiastową poprawę słuchu, która utrzymuje się przez 6-9 miesięcy. Po 12-18 miesiącach nie ma już różnicy między dziećmi, które miały wszczepiane dreny, a tymi, które nie miały zabiegu.
Adenoidektomia – zmniejsza częstość nawrotów ucha kleistego. Badania wykazują, że po 2 latach 50% dzieci po adenoidektomii ma nieprawidłową tympanometrię, w porównaniu do 83% uszu, które otrzymały tylko dreny.⁵⁹⁶⁰⁶¹

Wskazania do różnych metod leczenia

Wybór metody leczenia ucha kleistego zależy od kilku czynników:

Metoda leczenia	Wskazania	Zalety	Ograniczenia
Obserwacja	– Pierwszy epizod ucha kleistego – Łagodne objawy – Czas trwania < 3 miesięcy	– Nieinwazyjna – Brak działań niepożądanych – Duża szansa na samoistne ustąpienie	– Wymaga cierpliwości – Niedosłuch może wpływać na rozwój mowy
Autoinflacja (Otovent)	– Dzieci > 4 roku życia – Podczas okresu obserwacji – Jako uzupełnienie innych metod	– Nieinwazyjna – Niska cena – Brak działań niepożądanych	– Wymaga współpracy dziecka – Trudna do zastosowania u młodszych dzieci – Wymaga regularnego stosowania
Dreny wentylacyjne	– Ucho kleiste > 3 miesięcy – Znaczący niedosłuch – Opóźnienie rozwoju mowy	– Natychmiastowa poprawa słuchu – Skuteczne usunięcie płynu – Krótki zabieg	– Wymaga znieczulenia ogólnego – Ryzyko infekcji – Możliwe powikłania
Adenoidektomia	– Powiększone adenoidy – Częste infekcje górnych dróg oddechowych – Nawracające ucho kleiste – Dzieci > 4 roku życia	– Zmniejsza nawroty ucha kleistego – Poprawia funkcję trąbki słuchowej – Zmniejsza częstość infekcji	– Wymaga znieczulenia ogólnego – Bardziej inwazyjny zabieg – Możliwe powikłania
Aparaty słuchowe	– Przeciwwskazania do zabiegu – Preferencje rodziców/pacjenta – Nawracające ucho kleiste	– Nieinwazyjna metoda – Natychmiastowa poprawa słuchu – Odwracalna	– Nie leczy przyczyny ucha kleistego – Koszt aparatów – Konieczność noszenia urządzenia

Zalecenia przy wyborze terapii ucha kleistego

Podejmując decyzję o metodzie leczenia ucha kleistego, należy wziąć pod uwagę następujące aspekty:

Większość przypadków ucha kleistego ustępuje samoistnie w ciągu 3 miesięcy, dlatego początkowe podejście zazwyczaj polega na obserwacji.
Jeśli ucho kleiste utrzymuje się ponad 3 miesiące i powoduje niedosłuch, wskazana jest dalsza diagnostyka i leczenie.
Autoinflacja (Otovent) jest bezpieczną, nieinwazyjną metodą, którą można stosować jako pierwszą linię leczenia podczas okresu obserwacji.
Dreny wentylacyjne są efektywne, ale powinny być rozważane głównie w przypadkach utrzymującego się ucha kleistego z niedosłuchem i negatywnym wpływem na rozwój dziecka.
Aparaty słuchowe są dobrą alternatywą dla zabiegów chirurgicznych, szczególnie gdy pacjent nie może być poddany operacji.
Adenoidektomia powinna być rozważana jako uzupełnienie wszczepienia drenów, szczególnie u dzieci z nawracającym uchem kleistym i powiększonymi adenoidami.⁶²⁶³⁶⁴⁶⁵

Niezależnie od wybranej metody leczenia, ważne jest regularne monitorowanie stanu ucha i słuchu dziecka. Wczesna interwencja w przypadku ucha kleistego jest kluczowa dla zapobiegania długoterminowym problemom ze słuchem i opóźnieniom w rozwoju mowy i języka.⁶⁶⁶⁷

Kolejne rozdziały

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Materiały źródłowe

#1 Glue Ear (Otitis Media with Effusion): Symptoms & Causes
https://my.clevelandclinic.org/health/diseases/23523-glue-ear
Glue ear often goes away naturally without treatment. […] If your child’s symptoms don’t improve naturally, treatment options may include: […] If your child is experiencing any pain along with the buildup of fluid, they may have an ear infection. In this case, their provider may prescribe an antibiotic to clear it up. […] Your child’s specialist may perform a surgery called myringotomy. During this procedure, the specialist will make a small cut in your child’s eardrum to allow fluid to drain from their middle ear. […] If enlarged adenoids are the cause of your child’s glue ear, their specialist may perform an adenoidectomy. […] To help with temporary hearing loss, your child’s healthcare provider may recommend hearing aids. […] You may be able to treat your child’s glue ear at home. Glue ear exercises you can have your child try to temporarily clear their middle ear include:
#2 Treatment of glue ear with grommets | Great Ormond Street Hospital
https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/treatment-glue-ear-grommets/
If your child has a single case of glue ear, it may clear up by itself. However, if it continues and starts to affect their speech, language or schooling, the doctor may suggest treatment using grommets, which are inserted during an operation. […] Grommets are tiny tubes inserted into the eardrum. They allow air to pass through the eardrum, keeping the air pressure on either side equal. The surgeon makes a tiny hole in the eardrum and inserts the grommet into the hole. It usually stays in place for six to 12 months and then falls out. This is normal and wont affect your child. […] For persistent glue ear, grommets are the treatment of choice. Medical treatment with decongestants or steroids isnt particularly effective unless there are signs of infection or allergy. Antibiotics can help but only in the short term. […] Once weve diagnosed and treated glue ear, the outlook is good. Most children with speech and language delays catch up and go on to have a normal school life. A small proportion of children may need extra help from a speech and language therapist.
#3 Glue Ear (Otitis Media with Effusion): Symptoms & Causes
https://my.clevelandclinic.org/health/diseases/23523-glue-ear
The Otovent glue ear treatment helps drain fluid from your child’s ears. […] If your child’s healthcare provider recommends testing, they’ll refer you to a specialist such as an audiologist or an ear, nose and throat doctor. […] Your child’s healthcare provider will examine your child’s ears to diagnose glue ear. They’ll use a small scope to look for fluid in your child’s ears. […] Most cases of glue ear go away on their own within two to three weeks. […] If it hasn’t resolved on its own within three months, speak with your child’s healthcare provider about appropriate treatment.
#4 Otitis Media in Adults | Balloon Treatment for Glue Ear in Adults
https://www.otovent.co.uk/what-is-otovent-for/glue-ear-in-adults/
You should consult your GP if you are displaying any of the glue ear symptoms. If your GP suspects glue ear as the cause they will likely ask you to observe a âwatch and waitâ or âactive observationâ period. This happens because up to 50% of glue ear cases will spontaneously resolve without treatment. […] If your symptoms persist your GP will refer you to an Audiologist. Using a tympanometry test the Audiologist will diagnose glue ear. At the point of diagnosis, you will likely be asked to continue the active observation period. If the condition persists after this, they will either refer you back to your GP for an Otovent prescription or to an ENT surgeon for grommet surgery. […] The Otovent auto inflation device is available over the counter at your local pharmacy. You can also purchase it online. Otovent is the only clinically effective drug-free treatment for Glue Ear.
#5 Glue Ear: Causes, Symptoms, and Treatment
https://patient.info/ears-nose-throat-mouth/hearing-problems/glue-ear
Glue ear is a condition where the middle ear fills with glue-like fluid instead of air. This causes dulled hearing. In most cases it clears without any treatment. An operation to clear the fluid and to insert ventilation tubes (grommets) or temporary use of hearing aids may be advised if glue ear persists. […] Various medicines have been tried to help clear glue ear. For example, antihistamines, steroids, decongestants, antibiotics and medicines to thin mucus. However, research studies have shown that none of these medicines works in the treatment of glue ear. […] No treatment is usually advised at first as the outlook is good. Typically, a doctor may advise that you wait three months to see if the glue ear clears. Watchful waiting is sometimes called active monitoring. […] For this treatment a special balloon is blown up by the child using their nose. This is called auto-inflation. It puts back pressure into the nose and may help to open up the eustachian tube and allow better drainage of the fluid.
#6 Glue ear (otitis media with effusion) | healthdirect
https://www.healthdirect.gov.au/glue-ear
Glue ear (also known as 'otitis media with effusion’) is a condition where fluid builds up in the middle ear. […] If the fluid doesn’t clear up, it can be treated with tiny tubes called grommets that help the fluid drain. […] Glue ear often goes away on its own. Your doctor may suggest waiting and monitoring it without treatment. […] Sometimes, your doctor will prescribe antibiotics to help the fluid clear. […] If glue ear does not resolve on its own, there are a few treatment options your doctor may suggest: hearing aids if glue ear persists and affects hearing; grommets (ventilation tubes) if the fluid doesn’t go away and is causing hearing loss. These are inserted into the eardrums during a minor surgical procedure to help drain the fluid; adenoidectomy removing the glands in the back of the throat. This may reduce your risk of glue ear, especially if your adenoids are enlarged and are blocking the Eustachian tubes.
#7 Ear infections and glue ear
https://www.rch.org.au/kidsinfo/fact_sheets/ear_infections_and_otitis_media/
Glue ear is not an infection, but usually follows one or more middle ear infections. Signs and symptoms of glue ear can include: […] If your child is not bothered by the glue ear, no treatment is needed. It usually goes away by itself over time. […] Sometimes antibiotics are prescribed to kill any germs left in the middle ear, and this may help the fluid to clear. […] If the glue ear still persists and is affecting your child’s hearing over many months, your doctor or ENT specialist may suggest surgery. This is a quick operation during which small tubes (called grommets) are put into your child’s ear. These tubes help fluid drain from the middle ear. […] Most children outgrow middle ear problems (including glue ear), and have perfect and undamaged ears with normal hearing when they get older. […] Glue ear is caused by fluid that collects behind the eardrum, in the middle ear. It usually clears on its own with no treatment, but sometimes requires surgery to insert grommets for drainage. […] Hearing and speech development can be affected if glue ear is persistent.
#8 Glue ear | Healthify
https://healthify.nz/health-a-z/g/glue-ear
The best treatment for glue ear is time. For most children, episodes of glue ear get better without treatment. For this reason, your healthcare provider may simply recommend regular check-ups for up to 3 months so they can examine your child’s ears. […] If your child has fluid in the middle ear for more than 3 months, there are some treatment options. […] Some children with glue ear may need grommets. If your child does need grommets, your healthcare provider may recommend an appointment with an ENT (ear, nose and throat) specialist. […] Longer courses of antibiotics have been used in the past as treatment for glue ear. But, antibiotics only have a small temporary effect on clearing fluid from the middle ear. Because of this and concerns about the complications of long courses of antibiotics (including the development of antibiotic resistance, allergic reactions, diarrhoea and thrush), they are no longer a common treatment for glue ear. […] The following treatments don’t work don’t use these for your child: decongestants (such as Pseudoephedrine), antihistamines (such as Phenergan), steroids (such as Prednisone).
#9 Glue Ear: Symptoms, Causes, Treatment, and Prevention
https://www.healthline.com/health/glue-ear
Glue ear is diagnosed with an ear exam at your doctors office. Theyll use a magnified scope with a light attached to it to look inside your ear. This device can help them see where theres fluid buildup. […] Most cases of glue ear go away on their own. However, glue ear that turns into a middle ear infection may be treated with antibiotics. […] One way you can alleviate fluid buildup at home is through autoinflation. This involves blowing up a balloonlike device with each nostril. For best results, autoinflation is done several times a day. This method isnt recommended for children under age 3. […] Severe or chronic cases of glue ear may require treatment from a specialist, such as an ear nose and throat (ENT) doctor. […] Temporary hearing aids may be used to help improve auditory skills when middle ear fluid is present. If lack of hearing has impacted your childs developmental milestones, then your doctor might also recommend speech therapy.
#10 Glue ear treatment
https://verifiedhearing.com/glue-ear-treatment/
Grommets may not be suitable for everyone, particularly individuals with certain medical conditions or anatomical abnormalities that may increase the risks associated with the procedure. […] A bone conduction hearing aid is designed to transmit sound through the skull bone to the inner ear, which can then be processed by the brain as sound signals, bypassing this sticky fluid. […] Otovent is a balloon designed for treating glue ear at home and can speed up the recovery process. […] The three main options for treating glue ear are ear grommets, hearing aids, and Otovent glue ear treatment. […] Ear grommets can improve hearing, reduce the risk of ear infections, and alleviate symptoms such as ear pain, tinnitus, and dizziness. […] Bone Conduction hearing aids are a solution designed to bypass the sticky fluid in the middle ear by transmitting sound through the skull bone to the inner ear. […] Otovent is a balloon designed for treating glue ear at home and can speed up the recovery process. […] It is important to discuss the benefits, risks, and effectiveness of each treatment option with a healthcare professional to determine the most suitable option for each individual.
#11 Treat glue earwith OtoventÂ®
https://otovent.com/
Otovent is a well-documented aid that can be used if you or your child cannot equalize the pressure themselves. Otovent should always be used with an adult. […] Otovent has been used over 2 million times for more than 25 years to treat glue ear in both children and adults. […] Otovent is designed to open the eustachian tube and normalize the pressure around the eardrum. It is well documented for treating glue ear in children and adults.
#12
https://www.racgp.org.au/clinical-resources/clinical-guidelines/handi/handi-interventions/procedures/autoinflation-for-glue-ear-in-children
Use of an inflation device to open the eustachian tube (by raising intranasal pressure) and restore hearing. […] Raising the intranasal pressure can be achieved by exhaling against a closed airway (Valsalva manoeuvre), blowing air up the nose while swallowing (Politzer manoeuvre) or a combination of both. […] For children with deafness due to glue ear, autoinflation can avoid the need for tympanoplasty tubes (grommets). In a trial of using Otovent in children, 50% had tympanometric resolution by 3 months, compared with 38% of controls (NNT = 9). […] The balloon-based device Otovent is available from chemists and online for around $30. […] The air-pump device EarPopper is available online for $240. […] By blowing up a balloon using the nose, the child performs the Valsalva manoeuvre to increase pressure in the nasopharynx. During the deflation phase of the balloon, air is blown up the nose and the child can be encouraged to swallow, producing a Politzer manoeuvre.
#13
https://www.racgp.org.au/clinical-resources/clinical-guidelines/handi/handi-interventions/procedures/autoinflation-for-glue-ear-in-children
The device is used two to three times daily. During each session, the child inflates the balloon once via each nostril. […] The device is placed into one nostril and the other nostril is blocked. The device is activated (blowing air into the nose) and the patient swallows, producing a Politzer manoeuvre. […] Treatment may be repeated twice in each nostril, twice daily, and continued until symptoms resolve. […] In approximately one-third of affected children, symptoms will resolve without any treatment. […] Participation in using the balloon can be encouraged through the use of a sticker-book diary or wall chart. […] Devices come with written instructions and there are also videos available. Further training of parents/children on how to use the device could be provided by a GP or practice nurse during a single consultation.
#14 Blowing up a balloon with the nose helps restore hearing in children with glue ear
https://evidence.nihr.ac.uk/alert/blowing-up-a-balloon-with-the-nose-helps-restore-hearing-in-children-with-glue-ear/
The use of a simple nasal balloon can help restore hearing in children aged 4 to 11 with glue ear. After 3 months, this non-surgical treatment restored normal hearing to 49.6% of children with glue ear compared with 38.3% receiving usual care. […] Few non-surgical treatments exist for children with glue ear. […] Several small hospital based studies have found that a simple, non-surgical procedure using a nasal balloon device can be effective in resolving hearing loss caused by glue ear. […] The nasal balloon device a simple, low cost non-surgical treatment that can be taught by nurses in general practice restored normal hearing in up to half of children with glue ear by three months so should be considered a treatment option during this time. […] If you have a prescription for a child less than 16 years of age the treatment is free on the NHS.
#15 Glue ear balloon treatment avoids surgery – myDr.com.au
https://mydr.com.au/kids-teens-health/glue-ear-balloon-treatment-avoids-surgery/
Children over 4 with glue ear (known as otitis media with effusion) could now be treated with a simple non-surgical option involving blowing up a balloon with their nose, a study has found. […] The trial involved 320 children with recent glue ear, who had fluid in one or both ears, from 43 family practices in the UK. […] We have found the use of autoinflation in young, school-aged children with otitis media with effusion to be feasible, safe and effective in clearing effusions, and in improving important ear symptoms, concerns and related quality of life over a 3-month watch-and-wait period, the authors write. […] Now, at last, there is something effective to offer children with glue ear other than surgery. […] Parents interested in this technique should see their GP to see if it is suitable for their child and to have a demonstration. This technique should not be attempted without instruction.
#16 Otitis Media in Adults | Balloon Treatment for Glue Ear in Adults
https://www.otovent.co.uk/what-is-otovent-for/glue-ear-in-adults/
Drug-free and non-surgical, Otovent is an autoinflation device. The balloons included in the kit are specially pressurised to open the eustachian tube when inflated via the nose. This process allows the fluid associated with glue ear to safely drain away. […] Grommet surgery is a fifteen-minute operation carried out under general anaesthetic. A small plastic tube is inserted into the ear drum to drain fluid and maintain the correct pressure. Grommets will typically stay in for 6 â 12 months but in around 1/3 of cases can fall out before the glue ear is resolved. Repeat surgery can result in a scarred ear drum. […] NICE and the NHS do not recommend the following alternative treatments due to a lack of supporting clinical evidence: antibiotics, topical or systemic antihistamines, topical or systemic decongestants, topical or systemic steroids, homeopathy, cranial osteopathy, acupuncture, dietary modification, including probiotics, immunostimulants and massage.
#17 Glue Ear in Adults
https://www.gluear.co.uk/glue-ear-in-adults/
If you are displaying any of the glue ear symptoms you should consult your GP. Your GP will likely ask you to observe an âactive observationâ or âwatch and waitâ period if they suspect glue ear as the cause. This happens because roughly 50% of glue ear cases spontaneously resolve without the need for treatment. […] If your symptoms persist after the watch and wait period your GP will refer you to an Audiologist. The Audiologist will diagnose glue ear using a tympanometry test. You will probably be asked to continue the active observation period following diagnosis. If the condition continues after this, they will either refer you to your GP for an Otovent prescription or to an ENT surgeon for grommet surgery. […] The Otovent auto-inflation device is available free on prescription and over the counter at your local pharmacy. It can also be purchased from our transactional website, otovent.co.uk Otovent is the only clinically proven drug-free and non-surgical treatment for glue ear.
#18 Glue Ear: Causes, Symptoms, and Treatment
https://patient.info/ears-nose-throat-mouth/hearing-problems/glue-ear
Glue ear is a condition where the middle ear fills with glue-like fluid instead of air. This causes dulled hearing. In most cases it clears without any treatment. An operation to clear the fluid and to insert ventilation tubes (grommets) or temporary use of hearing aids may be advised if glue ear persists. […] Various medicines have been tried to help clear glue ear. For example, antihistamines, steroids, decongestants, antibiotics and medicines to thin mucus. However, research studies have shown that none of these medicines works in the treatment of glue ear. […] No treatment is usually advised at first as the outlook is good. Typically, a doctor may advise that you wait three months to see if the glue ear clears. Watchful waiting is sometimes called active monitoring. […] For this treatment a special balloon is blown up by the child using their nose. This is called auto-inflation. It puts back pressure into the nose and may help to open up the eustachian tube and allow better drainage of the fluid.
#19 Glue Ear (Otitis Media with Effusion): Symptoms & Causes
https://my.clevelandclinic.org/health/diseases/23523-glue-ear
Glue ear often goes away naturally without treatment. […] If your child’s symptoms don’t improve naturally, treatment options may include: […] If your child is experiencing any pain along with the buildup of fluid, they may have an ear infection. In this case, their provider may prescribe an antibiotic to clear it up. […] Your child’s specialist may perform a surgery called myringotomy. During this procedure, the specialist will make a small cut in your child’s eardrum to allow fluid to drain from their middle ear. […] If enlarged adenoids are the cause of your child’s glue ear, their specialist may perform an adenoidectomy. […] To help with temporary hearing loss, your child’s healthcare provider may recommend hearing aids. […] You may be able to treat your child’s glue ear at home. Glue ear exercises you can have your child try to temporarily clear their middle ear include:
#20 Ear infections and glue ear
https://www.rch.org.au/kidsinfo/fact_sheets/ear_infections_and_otitis_media/
Glue ear is not an infection, but usually follows one or more middle ear infections. Signs and symptoms of glue ear can include: […] If your child is not bothered by the glue ear, no treatment is needed. It usually goes away by itself over time. […] Sometimes antibiotics are prescribed to kill any germs left in the middle ear, and this may help the fluid to clear. […] If the glue ear still persists and is affecting your child’s hearing over many months, your doctor or ENT specialist may suggest surgery. This is a quick operation during which small tubes (called grommets) are put into your child’s ear. These tubes help fluid drain from the middle ear. […] Most children outgrow middle ear problems (including glue ear), and have perfect and undamaged ears with normal hearing when they get older. […] Glue ear is caused by fluid that collects behind the eardrum, in the middle ear. It usually clears on its own with no treatment, but sometimes requires surgery to insert grommets for drainage. […] Hearing and speech development can be affected if glue ear is persistent.
#21 Glue ear (otitis media with effusion) | healthdirect
https://www.healthdirect.gov.au/glue-ear
Glue ear (also known as 'otitis media with effusion’) is a condition where fluid builds up in the middle ear. […] If the fluid doesn’t clear up, it can be treated with tiny tubes called grommets that help the fluid drain. […] Glue ear often goes away on its own. Your doctor may suggest waiting and monitoring it without treatment. […] Sometimes, your doctor will prescribe antibiotics to help the fluid clear. […] If glue ear does not resolve on its own, there are a few treatment options your doctor may suggest: hearing aids if glue ear persists and affects hearing; grommets (ventilation tubes) if the fluid doesn’t go away and is causing hearing loss. These are inserted into the eardrums during a minor surgical procedure to help drain the fluid; adenoidectomy removing the glands in the back of the throat. This may reduce your risk of glue ear, especially if your adenoids are enlarged and are blocking the Eustachian tubes.
#22 Glue Ear – Otitis Media with Effusion (OME)
https://www.entuk.org/patients/conditions/4/glue_ear_otitis_media_with_effusion_ome/
Hearing aids: If your child still has problems with their hearing after a period of active monitoring, they may need treatment. A hearing aid can help. […] Surgery: Surgery to drain the fluid from your childs ears can help. The surgeon will usually insert small tubes into the eardrum at the same time to allow the fluid to keep draining. The tubes are called grommets. Removing the adenoid tissue at the back of the nose can also help. This operation is called an adenoidectomy. […] Is there any other treatment that will help the glue ear clear away more quickly? No. Antibiotics, antihistamines and other medications or interventions do not help. […] Your doctor will usually advise treating your childs glue ear if it does not clear up on its own. This reduces the chance of long-term damage to the ear. Treatment also reduces the chance of your child having problems with hearing and language later in life.
#23 Otitis Media with Effusion (Glue Ear) | Doctor
https://patient.info/doctor/otitis-media-with-effusion
Encouraging daily reading, which helps language development. […] Hearing aid use […] NICE recommends hearing aids for children with bilateral OME and hearing loss where surgery is not acceptable or is contra-indicated or if aiding is in line with parental or child preference. […] Pharmacological […] Medical management (eg, antibiotics, topical or systemic antihistamines or decongestants) is not recommended. […] High-quality evidence of multiple short- and long-term outcomes repeatedly and unequivocally demonstrated no benefit for use of antihistamines and decongestants over placebo for treating OME. Routine use of antibiotics is also not recommended. Additionally, side-effects and harms may occur with use of these medications. […] The treatment of adults with uncomplicated OME is generally extrapolated from that of children. If there is an underlying cause then this should be treated appropriately. There is a lack of clear evidence on the treatment of uncomplicated OME in adults.
#24 S-carboxymethylcysteine in the treatment of glue ear: quantitative systematic review
https://pmc.ncbi.nlm.nih.gov/articles/PMC57002/
To establish the clinical relevance of S-carboxymethylcysteine in the treatment of glue ear in children using measures approximating those saving a child from operation for grommet insertion. […] S-carboxymethylcysteine is effective in the treatment of children with glue ear. For every five or six children treated with S-carboxymethylcysteine over one to three months, one will not undergo surgery for grommet insertion who would have done had they been given placebo. […] S-carboxymethylcysteine was given as a syrup or linctus at various doses (sometimes age-related) for periods as little as 10 or 15 days, but other studies used it for between one and three months. […] Successful outcomes were obtained in 17% of children given placebo (range 5% to 38% in individual studies) and in 35% of children given S-carboxymethylcysteine (range 22 to 80%).
#25 S-carboxymethylcysteine in the treatment of glue ear: quantitative systematic review
https://pmc.ncbi.nlm.nih.gov/articles/PMC57002/
The combined data had a number-needed-to-treat of 5.5 (95% confidence interval 3.8 to 9.8). This means that for every five or six children treated with S-carboxymethylcysteine over one to three months, one will not undergo surgery for grommet insertion who would have done had they been given placebo. […] On average for every 100 children given S-carboxymethylcysteine in the seven trials, 35 would have avoided surgery (95% confidence interval 29 to 41). There was a consistent benefit for use of S-carboxymethylcysteine with an overall relative benefit of 2.0 (1.4 to 2.8). […] S-carboxymethylcysteine is likely to be a useful treatment of children during a period of watchful waiting before surgery. It spares about 18% of children an operation, and as well as being clinically effective an economic analysis showed it to be cost-effective when the number-needed-to-treat is better (lower) than 15.
#26 Otitis Media in Adults | Balloon Treatment for Glue Ear in Adults
https://www.otovent.co.uk/what-is-otovent-for/glue-ear-in-adults/
Drug-free and non-surgical, Otovent is an autoinflation device. The balloons included in the kit are specially pressurised to open the eustachian tube when inflated via the nose. This process allows the fluid associated with glue ear to safely drain away. […] Grommet surgery is a fifteen-minute operation carried out under general anaesthetic. A small plastic tube is inserted into the ear drum to drain fluid and maintain the correct pressure. Grommets will typically stay in for 6 â 12 months but in around 1/3 of cases can fall out before the glue ear is resolved. Repeat surgery can result in a scarred ear drum. […] NICE and the NHS do not recommend the following alternative treatments due to a lack of supporting clinical evidence: antibiotics, topical or systemic antihistamines, topical or systemic decongestants, topical or systemic steroids, homeopathy, cranial osteopathy, acupuncture, dietary modification, including probiotics, immunostimulants and massage.
#27 How to treat temporary deafness caused by glue ear | Glue ear
https://www.ndcs.org.uk/information-and-support/childhood-deafness/causes-of-deafness/glue-ear/treat-glue-ear/
The Otovent nasal balloon (also known as nasal balloon autoinflation) is a non-surgical, drug-free treatment option for glue ear. […] The Otovent may be helpful for some older children during the watchful waiting period or while waiting for grommet surgery. […] Hearing aids are devices designed to make sounds louder. They are used on a temporary basis for glue ear while waiting either for the glue ear to resolve or for grommet surgery. […] NICE currently recommends grommets or hearing aids as effective treatments for glue ear. […] At the current time NICE does not recommend using: steroids, antihistamines, decongestants, antibiotics, homeopathy, cranial osteopathy, acupuncture, massage, probiotics, changing the diet (for example, to reduce dairy), immunostimulants. […] We are here for all children and young people who are deaf or experience temporary hearing loss, including glue ear.
#28 Treatment of glue ear with grommets | Great Ormond Street Hospital
https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/treatment-glue-ear-grommets/
If your child has a single case of glue ear, it may clear up by itself. However, if it continues and starts to affect their speech, language or schooling, the doctor may suggest treatment using grommets, which are inserted during an operation. […] Grommets are tiny tubes inserted into the eardrum. They allow air to pass through the eardrum, keeping the air pressure on either side equal. The surgeon makes a tiny hole in the eardrum and inserts the grommet into the hole. It usually stays in place for six to 12 months and then falls out. This is normal and wont affect your child. […] For persistent glue ear, grommets are the treatment of choice. Medical treatment with decongestants or steroids isnt particularly effective unless there are signs of infection or allergy. Antibiotics can help but only in the short term. […] Once weve diagnosed and treated glue ear, the outlook is good. Most children with speech and language delays catch up and go on to have a normal school life. A small proportion of children may need extra help from a speech and language therapist.
#29 Glue ear (otitis media with effusion) | healthdirect
https://www.healthdirect.gov.au/glue-ear
Glue ear (also known as 'otitis media with effusion’) is a condition where fluid builds up in the middle ear. […] If the fluid doesn’t clear up, it can be treated with tiny tubes called grommets that help the fluid drain. […] Glue ear often goes away on its own. Your doctor may suggest waiting and monitoring it without treatment. […] Sometimes, your doctor will prescribe antibiotics to help the fluid clear. […] If glue ear does not resolve on its own, there are a few treatment options your doctor may suggest: hearing aids if glue ear persists and affects hearing; grommets (ventilation tubes) if the fluid doesn’t go away and is causing hearing loss. These are inserted into the eardrums during a minor surgical procedure to help drain the fluid; adenoidectomy removing the glands in the back of the throat. This may reduce your risk of glue ear, especially if your adenoids are enlarged and are blocking the Eustachian tubes.
#30 Glue Ear: Symptoms, Causes, Treatment, and Prevention
https://www.healthline.com/health/glue-ear
Chronic glue ear is sometimes treated with a type of surgery called an adenoidectomy. During this procedure, your doctor removes your adenoid glands from behind your nose that may be contributing to fluid buildup in your ear. […] During and after surgery, youll need to wear small tubes in your ears called grommets, commonly referred to as ear tubes or pressure equalizer tubes. These keep your eardrum open by allowing fluid to drain away from behind it. Grommets are only temporary though, and they usually fall out on their own within a year.
#31 Display Patient Information Leaflets
https://www.plymouthhospitals.nhs.uk/display-pil/pil-glue-ear-8101/
A hearing aid can help a child overcome the hearing loss associated with glue ear. It will give the condition chance to resolve on its own, without having surgery (grommets). […] Grommets are a surgical option to managing glue ear. A grommet is a tube that sits in a small hole in the eardrum. It can be made of plastic or metal. The most commonly used type is a plastic bobbin. Grommets are often recommended for the treatment of glue ear or recurrent ear infections. […] Grommets in children are always inserted under general anesthetic. This means your child will be asleep throughout the procedure and will not feel anything. […] A small hole is made in the eardrum, and the thick mucus is removed. The grommet is then placed in the hole. The procedure takes about 10 minutes to perform, with additional time for going to sleep and waking up.
#32 Glue ear in children: risk factors, symptoms and treatment | Spire Healthcare
https://www.spirehealthcare.com/health-hub/specialties/ear-nose-and-throat/glue-ear-in-children-risk-factors-symptoms-and-treatment/
There are two main options for treatment: grommet surgery and hearing aids. […] Grommet surgery is a quick surgery, performed under general anaesthesia, as a day case. It involves placing a tiny, hollow, plastic tube inside the ear drum. This allows air to circulate into the middle part of the ear. […] Around 70% of children who have grommet surgery are cured of glue ear by the time the grommet falls out. […] If you don’t want your child to have surgery, hearing aids can be fitted. However, hearing loss due to glue ear often varies through the day, which makes it difficult to apply settings on the hearing aids that will consistently provide the level of hearing needed.
#33 Glue ear in children: risk factors, symptoms and treatment | Spire Healthcare
https://www.spirehealthcare.com/health-hub/specialties/ear-nose-and-throat/glue-ear-in-children-risk-factors-symptoms-and-treatment/
There are two main options for treatment: grommet surgery and hearing aids. […] Grommet surgery is a quick surgery, performed under general anaesthesia, as a day case. It involves placing a tiny, hollow, plastic tube inside the ear drum. This allows air to circulate into the middle part of the ear. […] Around 70% of children who have grommet surgery are cured of glue ear by the time the grommet falls out. […] If you don’t want your child to have surgery, hearing aids can be fitted. However, hearing loss due to glue ear often varies through the day, which makes it difficult to apply settings on the hearing aids that will consistently provide the level of hearing needed.
#34 Display Patient Information Leaflets
https://www.plymouthhospitals.nhs.uk/display-pil/pil-glue-ear-8101/
Most grommets will fall out by themselves. Most plastic bobbin grommets last about 9 months, although some can fall out very early, and some may stay in longer. […] When the grommets have fallen out, the Eustachian tube will usually have started to work better and the glue ear will not return, but in about 1 in 5 cases, the glue will come back and further grommets may need to be inserted.
#35 Glue Ear (otitis media with effusion) – Ear, Balance and Eustachian Tube
https://earandbalance.co.uk/glue-ear-otitis-media-with-effusion/
Glue ear treatment options include: […] In most people glue ear will resolve after three months. […] This is a special device which the patient blows into using her or his nose. This is done three times a day for 6 weeks. […] A small (2-3mm) hole is made in the drum and a grommet (small plastic tubes) are placed in the ear drum after the fluid is drained. […] Their removal can help prevent and treat glue ear. […] In some children the hearing can be improved with hearing aids. […] The operation is carried out under general anaesthetic. […] The grommets can become infected and there may be a discharge from the ear. […] On rare occasions once the grommet comes out, the hole may not heal resulting in a perforation of the ear drum. […] Occasionally grommets can get blocked resulting in return of the glue ear. […] The child can resume normal activities the day following surgery. […] Grommets usually come out within 18 months. […] After the Grommet fall out glue ear can recur and further grommet insertion may be necessary.
#36 Otitis Media with Effusion (Glue Ear) | Doctor
https://patient.info/doctor/otitis-media-with-effusion
Children with better hearing, or only persistent unilateral hearing loss, but who have social, educational or developmental difficulties. They may exceptionally also benefit from surgical treatment. […] Insertion of grommets – ventilation tubes […] NICE concludes that insertion of grommets results in an improvement in hearing over a twelve-month period, which starts to tail off after six months. There is little evidence that language or speech development improves in the long term but significant short term in improvements in speech progression and overall development may be seen. […] Tympanosclerosis frequently occurs after grommet insertion, although the long-term consequences of this are uncertain. […] Infection after grommet insertion may occur. This can be managed with non-ototoxic topical antibiotic ear drops (eg, ciprofloxacin) for 5 to 7 days if otorrhoea occurs following grommet insertion. There is also a slightly increased incidence of chronic perforation.
#37 Glue Ear (otitis media with effusion) – Ear, Balance and Eustachian Tube
https://earandbalance.co.uk/glue-ear-otitis-media-with-effusion/
Glue ear treatment options include: […] In most people glue ear will resolve after three months. […] This is a special device which the patient blows into using her or his nose. This is done three times a day for 6 weeks. […] A small (2-3mm) hole is made in the drum and a grommet (small plastic tubes) are placed in the ear drum after the fluid is drained. […] Their removal can help prevent and treat glue ear. […] In some children the hearing can be improved with hearing aids. […] The operation is carried out under general anaesthetic. […] The grommets can become infected and there may be a discharge from the ear. […] On rare occasions once the grommet comes out, the hole may not heal resulting in a perforation of the ear drum. […] Occasionally grommets can get blocked resulting in return of the glue ear. […] The child can resume normal activities the day following surgery. […] Grommets usually come out within 18 months. […] After the Grommet fall out glue ear can recur and further grommet insertion may be necessary.
#38 Glue Ear (Otitis Media with Effusion): Symptoms & Causes
https://my.clevelandclinic.org/health/diseases/23523-glue-ear
Glue ear often goes away naturally without treatment. […] If your child’s symptoms don’t improve naturally, treatment options may include: […] If your child is experiencing any pain along with the buildup of fluid, they may have an ear infection. In this case, their provider may prescribe an antibiotic to clear it up. […] Your child’s specialist may perform a surgery called myringotomy. During this procedure, the specialist will make a small cut in your child’s eardrum to allow fluid to drain from their middle ear. […] If enlarged adenoids are the cause of your child’s glue ear, their specialist may perform an adenoidectomy. […] To help with temporary hearing loss, your child’s healthcare provider may recommend hearing aids. […] You may be able to treat your child’s glue ear at home. Glue ear exercises you can have your child try to temporarily clear their middle ear include:
#39 Glue Ear: Symptoms, Causes, Treatment, and Prevention
https://www.healthline.com/health/glue-ear
Chronic glue ear is sometimes treated with a type of surgery called an adenoidectomy. During this procedure, your doctor removes your adenoid glands from behind your nose that may be contributing to fluid buildup in your ear. […] During and after surgery, youll need to wear small tubes in your ears called grommets, commonly referred to as ear tubes or pressure equalizer tubes. These keep your eardrum open by allowing fluid to drain away from behind it. Grommets are only temporary though, and they usually fall out on their own within a year.
#40 What is the best treatment for glue ear? | Sri Ramakrishna Hospital
https://www.sriramakrishnahospital.com/blog/ent/what-is-the-best-treatment-for-glue-ear/
If the glue ear persists, surgery to drain the fluid and insert ventilation tubes (grommets) is suggested. […] Glue ear can sometimes clear up on its own without medical intervention. It is common for your childâs doctor to wait many months to see whether the fluid goes out independently. […] Some possible glue ear treatments for your childâs symptoms if they donât improve on their own: […] Myringotomy is a surgical procedure that may be recommended by your childâs doctor at a Coimbatore ent hospital. The doctor will make a tiny incision in your childâs eardrum to facilitate fluid movement from the middle ear. […] Your child may need an adenoidectomy if your ENT determines that swollen adenoids are to blame for their sticky ear. […] An assistive listening device, or hearing aid, is an instrument that boosts audible volume. Your childâs doctor may suggest hearing aids to help with temporary hearing loss. […] Grommets may be helpful if glue ear lasts longer than three months, returns frequently, or negatively impacts hearing. Grommets are tiny plastic tubes inserted into the eardrum to restore ventilation to the middle ear.
#41 ENTchild: glue ear
https://www.entchild.com/glue-ear
Glue Ear management is based on recommended guidelines such as those from the National Institute for Health and Care Excellence. Grommet surgery is not funded by the NHS unless specific criteria are met. Have a look at the grommets page to see what will need to happen before surgery will be funded. […] If Glue Ear is still there three months later, and affects hearing in both ears, then you may be offered treatment with grommets or hearing aids. Both are acceptable treatments. […] The main treatment of Glue Ear is grommets, as this deals with the Glue Ear fluid, but you may also hear your doctor talk about adenoid removal. For Glue Ear, removing adenoids is something that surgeons usually consider in children aged 4 years or older, if they have lots of snotty noses and upper respiratory tract infections.
#42 Otitis Media with Effusion (Glue Ear) | Doctor
https://patient.info/doctor/otitis-media-with-effusion
Grommet insertion has traditionally been performed under general anaesthetic, although it is possible to perform the procedure under local anaesthetic. Topical anaesthetic is applied to the ear canal approximately 30 minutes prior to the procedure. […] Adenoidectomy When planning grommet insertion for management of OME, adjuvant adenoidectomy should be considered. There is evidence that adenoidectomy with or without unilateral or bilateral grommet insertion reduces the presence or persistence of OME and in turn, this may have beneficial effects on hearing. However, adenoidectomy may cause velopharyngeal insufficiency or nasal regurgitation in children with palate abnormalities and so adenoidectomy should be avoided in this cohort.
#43 TREATMENT FOR GLUE EAR.logo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b
https://www.jwatch.org/jw199007200000005/1990/07/20/treatment-glue-ear
Glue ear, or otitis media with effusion, is the leading reason for elective surgery in children. Despite a number of studies comparing different treatment approaches, there is still uncertainty about the best surgical approach. This British study randomized 149 four- to nine-year-old children with glue ear to four treatment groups: 1) adenoidectomy, bilateral myringotomy, and unilateral tympanostomy tube; 2) adenoidectomy, unilateral myringotomy, and unilateral tympanostomy tube; and 3) and 4) the same as groups 1 and 2, respectively, but without adenoidectomy. The children were followed for 24 months and assessed for hearing function, middle ear function, and parental satisfaction with outcome. […] The presence of a tympanostomy tube was associated with improved hearing for up to 12 months; after that, its advantage disappeared. Addition of adenoidectomy led to sustained improvement in middle-ear function; at two years, 50 percent of children who underwent adenoidectomy had abnormal tympanometry, compared with 83 percent of ears that received myringotomy plus tympanostomy alone and 93 percent of ears that received myringotomy alone or no treatment. […] The authors conclude that the tympanostomy tube is most appropriate approach for restoration of hearing, with addition of adenoidectomy to improve middle-ear function.
#44 Ear Infections and âGlue Earâ: Healthy Ears, Happy Child – Adelaide ENT SpecialistsAdelaide ENT Specialists
https://www.adelaideentspecialists.com.au/2015/12/ear-infections-and-glue-ear-healthy-ears-happy-child/
Adenoidectomy is sometimes advocated as an adjunctive (and occasionally as an alternative) procedure to grommets. Adenoids can become chronically inflamed and be a reservoir of bacteria, causing protracted inflammation of the Eustachian tubes. Removal of the adenoids is a relatively straightforward procedure that can help address this problem.
#45 Glue Ear (Otitis Media with Effusion): Symptoms & Causes
https://my.clevelandclinic.org/health/diseases/23523-glue-ear
Glue ear often goes away naturally without treatment. […] If your child’s symptoms don’t improve naturally, treatment options may include: […] If your child is experiencing any pain along with the buildup of fluid, they may have an ear infection. In this case, their provider may prescribe an antibiotic to clear it up. […] Your child’s specialist may perform a surgery called myringotomy. During this procedure, the specialist will make a small cut in your child’s eardrum to allow fluid to drain from their middle ear. […] If enlarged adenoids are the cause of your child’s glue ear, their specialist may perform an adenoidectomy. […] To help with temporary hearing loss, your child’s healthcare provider may recommend hearing aids. […] You may be able to treat your child’s glue ear at home. Glue ear exercises you can have your child try to temporarily clear their middle ear include:
#46 Glue Ear: Causes, Symptoms, and Treatment
https://patient.info/ears-nose-throat-mouth/hearing-problems/glue-ear
A small operation may be advised by an ear specialist if your child’s glue ear persists, or is severe. This involves inserting small tubes called grommets. […] Hearing aids are an option instead of an operation to insert grommets in children with hearing loss who have glue ear in both ears. The hearing aids would usually only be used for the time until the glue ear clears away.
#47 How to treat temporary deafness caused by glue ear | Glue ear
https://www.ndcs.org.uk/information-and-support/childhood-deafness/causes-of-deafness/glue-ear/treat-glue-ear/
The Otovent nasal balloon (also known as nasal balloon autoinflation) is a non-surgical, drug-free treatment option for glue ear. […] The Otovent may be helpful for some older children during the watchful waiting period or while waiting for grommet surgery. […] Hearing aids are devices designed to make sounds louder. They are used on a temporary basis for glue ear while waiting either for the glue ear to resolve or for grommet surgery. […] NICE currently recommends grommets or hearing aids as effective treatments for glue ear. […] At the current time NICE does not recommend using: steroids, antihistamines, decongestants, antibiotics, homeopathy, cranial osteopathy, acupuncture, massage, probiotics, changing the diet (for example, to reduce dairy), immunostimulants. […] We are here for all children and young people who are deaf or experience temporary hearing loss, including glue ear.
#48 Glue ear treatment
https://verifiedhearing.com/glue-ear-treatment/
Grommets may not be suitable for everyone, particularly individuals with certain medical conditions or anatomical abnormalities that may increase the risks associated with the procedure. […] A bone conduction hearing aid is designed to transmit sound through the skull bone to the inner ear, which can then be processed by the brain as sound signals, bypassing this sticky fluid. […] Otovent is a balloon designed for treating glue ear at home and can speed up the recovery process. […] The three main options for treating glue ear are ear grommets, hearing aids, and Otovent glue ear treatment. […] Ear grommets can improve hearing, reduce the risk of ear infections, and alleviate symptoms such as ear pain, tinnitus, and dizziness. […] Bone Conduction hearing aids are a solution designed to bypass the sticky fluid in the middle ear by transmitting sound through the skull bone to the inner ear. […] Otovent is a balloon designed for treating glue ear at home and can speed up the recovery process. […] It is important to discuss the benefits, risks, and effectiveness of each treatment option with a healthcare professional to determine the most suitable option for each individual.
#49
https://www.oticonmedical.com/uk/info/glue-ear
As Glue Ear is a temporary problem, you may wonder why it is important to treat your child whilst they have the condition. There have been many studies that show the importance of young children being able to hear during their early years. Stable hearing helps the hearing nerve pathways develop properly and avoids any delay in speech development, so treating your child as quickly as possible is important. […] There are many options available to treat glue ear. The most common treatment options being Bone Conduction Hearing Processors, temporary conventional hearing aids or an operation to put a grommet into the ear drum. Your audiologist may have recommended that your child uses a Bone Conduction Solution. […] Bone is brilliant at carrying sound waves and this clever fact enables the processor, to take the sound from the outside, straight through into the Cochlea by using the bone to carry the waves. This means that the sound does not have to try to battle its way through the sticky mucus and will give a more constant level of sound that is clearer than some treatment options.
#50 Glue ear – Alder Hey Children’s Hospital Trust Glue ear
https://www.alderhey.nhs.uk/conditions/patient-information-leaflets/glue-ear/
Glue ear can cause a temporary hearing loss, which can range from mild to moderate. This can have adverse effects on a childâs speech, language, and behavioural development in a key stage of their life. […] At Alder Hey, as most cases of glue ear will resolve spontaneously within 3 to 6 months, we would apply a watchful wait period and review in 3 to 6 months for a retest of hearing. If the glue ear is still present and causing an associated hearing loss, we will discuss different management options. Such as: […] If the glue ear is having a significant impact on the childâs ability to hear, we can also consider fitting a temporary hearing aid worn on a headband (contact mini bone conduction hearing aid, discussed below). […] Children may have a conductive hearing loss which means that the earâs ability to conduct sound into the inner ear is blocked or reduced. Although this is often temporary, a child may be fitted with a contact mini bone conduction hearing aid to enable them to hear clearly whilst the problem persists.
#51 Otitis Media with Effusion (Glue Ear) | Doctor
https://patient.info/doctor/otitis-media-with-effusion
Otitis media with effusion treatment and management […] OME management in children […] Advice Give written information about OME to parents of affected children and reassure parents that: […] OME is a self-limiting illness and 90% of children will have complete resolution within one year, although recurrence is common. […] There is no proven benefit from treatment with any medication or alternative therapy. […] Parental smoking increases the risk of OME. […] Advise parents of children with hearing loss that hearing tactics can be used to facilitate communication. Parents and caregivers can assist by: […] Facing their child when speaking to them. […] Slowing their speech. […] Keeping speech clear. […] Increasing speech volume slightly. […] Turning off competing stimuli such as radio or TV.
#52 Otitis Media with Effusion (Glue Ear) | Doctor
https://patient.info/doctor/otitis-media-with-effusion
Encouraging daily reading, which helps language development. […] Hearing aid use […] NICE recommends hearing aids for children with bilateral OME and hearing loss where surgery is not acceptable or is contra-indicated or if aiding is in line with parental or child preference. […] Pharmacological […] Medical management (eg, antibiotics, topical or systemic antihistamines or decongestants) is not recommended. […] High-quality evidence of multiple short- and long-term outcomes repeatedly and unequivocally demonstrated no benefit for use of antihistamines and decongestants over placebo for treating OME. Routine use of antibiotics is also not recommended. Additionally, side-effects and harms may occur with use of these medications. […] The treatment of adults with uncomplicated OME is generally extrapolated from that of children. If there is an underlying cause then this should be treated appropriately. There is a lack of clear evidence on the treatment of uncomplicated OME in adults.
#53 Treatment of glue ear with grommets | Great Ormond Street Hospital
https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/treatment-glue-ear-grommets/
If your child has a single case of glue ear, it may clear up by itself. However, if it continues and starts to affect their speech, language or schooling, the doctor may suggest treatment using grommets, which are inserted during an operation. […] Grommets are tiny tubes inserted into the eardrum. They allow air to pass through the eardrum, keeping the air pressure on either side equal. The surgeon makes a tiny hole in the eardrum and inserts the grommet into the hole. It usually stays in place for six to 12 months and then falls out. This is normal and wont affect your child. […] For persistent glue ear, grommets are the treatment of choice. Medical treatment with decongestants or steroids isnt particularly effective unless there are signs of infection or allergy. Antibiotics can help but only in the short term. […] Once weve diagnosed and treated glue ear, the outlook is good. Most children with speech and language delays catch up and go on to have a normal school life. A small proportion of children may need extra help from a speech and language therapist.
#54 Glue Ear: Symptoms, Causes, Treatment, and Prevention
https://www.healthline.com/health/glue-ear
Glue ear is diagnosed with an ear exam at your doctors office. Theyll use a magnified scope with a light attached to it to look inside your ear. This device can help them see where theres fluid buildup. […] Most cases of glue ear go away on their own. However, glue ear that turns into a middle ear infection may be treated with antibiotics. […] One way you can alleviate fluid buildup at home is through autoinflation. This involves blowing up a balloonlike device with each nostril. For best results, autoinflation is done several times a day. This method isnt recommended for children under age 3. […] Severe or chronic cases of glue ear may require treatment from a specialist, such as an ear nose and throat (ENT) doctor. […] Temporary hearing aids may be used to help improve auditory skills when middle ear fluid is present. If lack of hearing has impacted your childs developmental milestones, then your doctor might also recommend speech therapy.
#55 Glue Ear in Adults
https://www.gluear.co.uk/glue-ear-in-adults/
If you are displaying any of the glue ear symptoms you should consult your GP. Your GP will likely ask you to observe an âactive observationâ or âwatch and waitâ period if they suspect glue ear as the cause. This happens because roughly 50% of glue ear cases spontaneously resolve without the need for treatment. […] If your symptoms persist after the watch and wait period your GP will refer you to an Audiologist. The Audiologist will diagnose glue ear using a tympanometry test. You will probably be asked to continue the active observation period following diagnosis. If the condition continues after this, they will either refer you to your GP for an Otovent prescription or to an ENT surgeon for grommet surgery. […] The Otovent auto-inflation device is available free on prescription and over the counter at your local pharmacy. It can also be purchased from our transactional website, otovent.co.uk Otovent is the only clinically proven drug-free and non-surgical treatment for glue ear.
#56 Glue Ear in Adults
https://www.gluear.co.uk/glue-ear-in-adults/
Non-surgical and drug-free, Otovent is an auto-inflation device. The balloons inside the kit are specially pressurised for opening the eustachian tube when inflated through the nose. This process allows the fluid associated with glue ear to safely drain away. […] Grommet surgery is difficult to obtain via the NHS, it is carried out under general anaesthetic and takes about fifteen minutes. A small plastic tube is inserted into the ear drum maintaining the correct pressure and allowing the fluid associated with glue ear to drain. Grommets typically stay in place for 6 â 12 months but in approximately â of cases can fall out prior to the glue ear being resolved. Repeat surgery can result in ear drum scarring. […] The following alternative treatments are not recommended by NICE or the NHS due to a lack of supporting clinical evidence: topical or systemic antihistamines, topical or systemic steroids, antibiotics, topical or systemic decongestants, cranial osteopathy, homeopathy, dietary modification including probiotics, immunostimulants, acupuncture and massage.
#57
https://www.bootshearingcare.com/conditions/glue-ear/
A lot of the time glue ear goes away on its own after 3 months, but if you are still having a persistent problem with your hearing then its important to seek out appropriate medical care. Treatments for glue ear include: […] Remember, glue ear cannot be treated with over-the-counter or prescription medication. If you still are uncertain or think you have it, go to a qualified medical professional for confirmation and diagnosis. […] Treatment options for glue ear in adults often involve a combination of approaches. These may include: Watchful waiting: in some cases, especially if symptoms are mild, a watchful waiting approach may be recommended. Hearing aids: for those with significant hearing loss, hearing aids can be beneficial in improving auditory function. Steroid nasal sprays: these may be prescribed to address any underlying inflammation in the Eustachian tubes. Surgical intervention: in persistent cases, surgical procedures like the insertion of ventilation tubes may be considered to alleviate symptoms. […] If you suspect glue ear or experience any related symptoms, consulting with a healthcare professional is essential for accurate diagnosis and personalized management.
#58 Glue ear – RNID
https://rnid.org.uk/information-and-support/ear-health/common-ear-conditions/glue-ear/
Glue ear, also known as otitis media with effusion (OME), is much more common in young children but it can sometimes also affect adults. Glue ear is the build up of fluid in the middle ear (the space behind the ear drum). It often develops after otitis media (middle ear infection). […] In children, most cases of glue ear clear up naturally within 3 months. If it doesnât get better, an ear, nose and throat (ENT) surgeon may recommend an operation where a tiny ventilation tube called a grommet is inserted temporarily into the eardrum. This allows air into the middle ear, helping to keep the middle ear space healthy. […] Hearing aids may be recommended if surgery isnât suitable because of other health problems, or if there is another reason to avoid inserting grommets â for example, if grommets havenât worked in the past and glue ear keeps coming back. […] OME is much less common in adults. Your doctor may refer you to an ENT specialist to investigate whatâs caused it.
#59 Operations for glue ear | LittleEars
https://www.littleears.soton.ac.uk/operations-glue-ear
Grommet surgery involves a small operation under general anaesthetic where fluid is drained from the middle ear and a ventilation tube (grommet) is inserted in the eardrum to allow air into the middle ear. […] Removing the fluid from the middle ear helps the sound vibrations transfer to the inner ear to improve hearing, and the grommet keeps the air flowing into the middle ear to stop the glue ear returning. […] Grommet surgery is an important treatment for a small minority of children with long term glue ear in both ears, and with speech, language and educational development problems. […] Grommet surgery is an effective, short-term treatment for glue ear. Hearing levels are improved for the first 6-9 months after the operation, but by 12-18 months there is no difference between those children who did and did not have surgery (children who don’t have surgery get better on their own).
#60 TREATMENT FOR GLUE EAR.logo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b
https://www.jwatch.org/jw199007200000005/1990/07/20/treatment-glue-ear
Glue ear, or otitis media with effusion, is the leading reason for elective surgery in children. Despite a number of studies comparing different treatment approaches, there is still uncertainty about the best surgical approach. This British study randomized 149 four- to nine-year-old children with glue ear to four treatment groups: 1) adenoidectomy, bilateral myringotomy, and unilateral tympanostomy tube; 2) adenoidectomy, unilateral myringotomy, and unilateral tympanostomy tube; and 3) and 4) the same as groups 1 and 2, respectively, but without adenoidectomy. The children were followed for 24 months and assessed for hearing function, middle ear function, and parental satisfaction with outcome. […] The presence of a tympanostomy tube was associated with improved hearing for up to 12 months; after that, its advantage disappeared. Addition of adenoidectomy led to sustained improvement in middle-ear function; at two years, 50 percent of children who underwent adenoidectomy had abnormal tympanometry, compared with 83 percent of ears that received myringotomy plus tympanostomy alone and 93 percent of ears that received myringotomy alone or no treatment. […] The authors conclude that the tympanostomy tube is most appropriate approach for restoration of hearing, with addition of adenoidectomy to improve middle-ear function.
#61 Operations for glue ear | LittleEars
https://www.littleears.soton.ac.uk/operations-glue-ear
Grommet surgery does not cure the underlying cause of glue ear. Instead it improves hearing to allow for normal learning and development whilst children grow out of glue ear. […] Having grommet surgery means that your child will need to have a general anaesthetic. Often children will have ear discharge after surgery, and there is a small risk of scarring or permanent perforation of the eardrum. […] Grommets normally fall out of the eardrum after 6-12 months and in up to 50% of cases another operation is needed within 5 years. […] Removing [the adenoids] can help the Eustachian tubes work better and help with glue ear.
#62 OME | aarontrinidade
https://www.aarontrinidade.com/ome
Glue ear (also known as otitis media with effusion) is an inflammation of the middle ear resulting in an accumulation of fluid without symptoms of infection. […] The majority of cases (approximately 75%) will spontaneously resolve with a wait and see approach, which is usually undertaken for approximately 3 months. During this time, an Otovent device can be tried. This is a special balloon that the child blows up with their nose in an attempt to force air up the Eustachian tubes and encourage a resolution of the fluid collection in the middle ear. In many cases an Otovent device can hasten resolution of the glue ear. […] Antibiotics and nasal decongestants have not been shown to be useful in the treatment of glue ear. […] For children who do not recover naturally after a 3-month period of watchful waiting and still have evidence of glue in both ears, ventilation tubes (grommets) can be inserted. These tubes allow ventilation of the middle ear by bypassing the dysfunctional Eustachian tube, and prevent the build up of fluid or pus behind the ear drum.
#63 OME | aarontrinidade
https://www.aarontrinidade.com/ome
No. Natural resolution of glue can take longer in some children. As a good alternative to surgery, children may try hearing aids as a temporary solution to their hearing difficulty and stop wearing them after the glue finally resolves. […] For children with Down syndrome, hearing aids are usually recommended as a first line of treatment over grommets as grommets tend to give more problems in these children, such as a higher rate of grommet infections and early extrusion of the grommets from the ear. […] No. Many children with glue ear will be diagnosed on a routine examination and have no symptoms at all, nor will their speech or school work be affected. In these children, simply watching and waiting until it resolves can be enough. Only children who are struggling with poor hearing or other symptoms and not showing signs of improvement over time need treatment. Otherwise, uncomplicated glue ear is not harmful to your child.
#64 Glue ear: thereâs a better alternative to grommet surgery
https://theconversation.com/glue-ear-theres-a-better-alternative-to-grommet-surgery-212660
Glue ear or secretory otitis media, to give it its medical name, is caused by a build up of fluid in the middle ear. […] The default treatment for glue ear is grommet surgery, which is where a small tube is inserted in the eardrum to regulate the pressure in the middle ear. However, surgery is costly and not risk free. There is also a lack of good-quality evidence that surgery achieves a long-term solution to recurrent bouts of glue ear. […] Because glue ear does spontaneously fix itself most countries clinical guidelines recommend waiting three months before any intervention. The most common form of intervention after this period is grommet surgery. […] There are, of course, alternatives to surgery, such as auto-inflation. […] The new generation of auto-inflation device to treat glue ear.
#65 Glue ear: thereâs a better alternative to grommet surgery
https://theconversation.com/glue-ear-theres-a-better-alternative-to-grommet-surgery-212660
The new generation devices, which look like a toy, allow children as young as one year to be treated for chronic glue ear, with up to 80% of patients getting significant relief from the symptoms. […] The golden rule in medicine is that surgery should be the last resort, but in the case of glue ear, it seems to be the default. We need a change in medical culture, and the question should always be: is there a better, less invasive procedure we can use?
#66 Causes of glue ear | Information about glue ear
https://www.ndcs.org.uk/information-and-support/childhood-deafness/causes-of-deafness/glue-ear/
Glue ear is a condition that affects 8 out of 10 children in the UK. We wanted to help people understand more about the condition and how it can be treated. […] You can find more information about treating glue ear and grommets here. […] Find out more about the different treatment options for glue ear here. […] If the symptoms continue your GP, health visitor or school nurse can refer you to the audiology or ear, nose and throat (ENT) department at your local hospital. […] If your child has glue ear your GP may describe their ear or ears as being congested. […] If there is any pain or sign of infection your GP may prescribe a course of antibiotics. […] The audiologist should explain the results of all the tests and discuss the best way to manage your child’s symptoms. […] If your child’s glue ear is lasting for a long time and impacting on their education, they may be regarded as having special or additional educational needs.
#67 Causes of glue ear | Information about glue ear
https://www.ndcs.org.uk/information-and-support/childhood-deafness/causes-of-deafness/glue-ear/
If your child’s glue ear is likely to, or has, lasted for at least 12 months, without clearing up, then your child may be regarded as having a disability under the Equality Act. […] We are here for all children and young people who are deaf or experience temporary hearing loss, including glue ear.

Ucho kleiste (otitis media z efuzją) Leczenie

Ucho kleiste (otitis media z efuzją) – metody leczenia

Obserwacja i samoistne ustępowanie

Metody nieinwazyjne leczenia ucha kleistego

Autoinflacja – metoda balonikowa

Farmakoterapia

Metody inwazyjne leczenia ucha kleistego

Dreny wentylacyjne (grommety)

Adenoidektomia

Aparaty słuchowe w leczeniu ucha kleistego

Strategie wspomagające leczenie ucha kleistego

Leczenie ucha kleistego u dorosłych

Efektywność leczenia ucha kleistego

Wskazania do różnych metod leczenia

Zalecenia przy wyborze terapii ucha kleistego

Kolejne rozdziały

Materiały źródłowe

#1 Glue Ear (Otitis Media with Effusion): Symptoms & Causeshttps://my.clevelandclinic.org/health/diseases/23523-glue-ear

#2 Treatment of glue ear with grommets | Great Ormond Street Hospitalhttps://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/treatment-glue-ear-grommets/

#3 Glue Ear (Otitis Media with Effusion): Symptoms & Causeshttps://my.clevelandclinic.org/health/diseases/23523-glue-ear

#4 Otitis Media in Adults | Balloon Treatment for Glue Ear in Adultshttps://www.otovent.co.uk/what-is-otovent-for/glue-ear-in-adults/

#5 Glue Ear: Causes, Symptoms, and Treatmenthttps://patient.info/ears-nose-throat-mouth/hearing-problems/glue-ear

#6 Glue ear (otitis media with effusion) | healthdirecthttps://www.healthdirect.gov.au/glue-ear

#7 Ear infections and glue earhttps://www.rch.org.au/kidsinfo/fact_sheets/ear_infections_and_otitis_media/

#8 Glue ear | Healthifyhttps://healthify.nz/health-a-z/g/glue-ear

#9 Glue Ear: Symptoms, Causes, Treatment, and Preventionhttps://www.healthline.com/health/glue-ear

#10 Glue ear treatmenthttps://verifiedhearing.com/glue-ear-treatment/

#11 Treat glue earwith OtoventÂ®https://otovent.com/

#12https://www.racgp.org.au/clinical-resources/clinical-guidelines/handi/handi-interventions/procedures/autoinflation-for-glue-ear-in-children

#13https://www.racgp.org.au/clinical-resources/clinical-guidelines/handi/handi-interventions/procedures/autoinflation-for-glue-ear-in-children

#14 Blowing up a balloon with the nose helps restore hearing in children with glue earhttps://evidence.nihr.ac.uk/alert/blowing-up-a-balloon-with-the-nose-helps-restore-hearing-in-children-with-glue-ear/

#15 Glue ear balloon treatment avoids surgery – myDr.com.auhttps://mydr.com.au/kids-teens-health/glue-ear-balloon-treatment-avoids-surgery/

#16 Otitis Media in Adults | Balloon Treatment for Glue Ear in Adultshttps://www.otovent.co.uk/what-is-otovent-for/glue-ear-in-adults/

#17 Glue Ear in Adultshttps://www.gluear.co.uk/glue-ear-in-adults/

#18 Glue Ear: Causes, Symptoms, and Treatmenthttps://patient.info/ears-nose-throat-mouth/hearing-problems/glue-ear

#19 Glue Ear (Otitis Media with Effusion): Symptoms & Causeshttps://my.clevelandclinic.org/health/diseases/23523-glue-ear

#20 Ear infections and glue earhttps://www.rch.org.au/kidsinfo/fact_sheets/ear_infections_and_otitis_media/

#21 Glue ear (otitis media with effusion) | healthdirecthttps://www.healthdirect.gov.au/glue-ear

#22 Glue Ear – Otitis Media with Effusion (OME)https://www.entuk.org/patients/conditions/4/glue_ear_otitis_media_with_effusion_ome/

#23 Otitis Media with Effusion (Glue Ear) | Doctorhttps://patient.info/doctor/otitis-media-with-effusion

#24 S-carboxymethylcysteine in the treatment of glue ear: quantitative systematic reviewhttps://pmc.ncbi.nlm.nih.gov/articles/PMC57002/

#25 S-carboxymethylcysteine in the treatment of glue ear: quantitative systematic reviewhttps://pmc.ncbi.nlm.nih.gov/articles/PMC57002/

#26 Otitis Media in Adults | Balloon Treatment for Glue Ear in Adultshttps://www.otovent.co.uk/what-is-otovent-for/glue-ear-in-adults/

#27 How to treat temporary deafness caused by glue ear | Glue earhttps://www.ndcs.org.uk/information-and-support/childhood-deafness/causes-of-deafness/glue-ear/treat-glue-ear/

#28 Treatment of glue ear with grommets | Great Ormond Street Hospitalhttps://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/treatment-glue-ear-grommets/

#29 Glue ear (otitis media with effusion) | healthdirecthttps://www.healthdirect.gov.au/glue-ear

#30 Glue Ear: Symptoms, Causes, Treatment, and Preventionhttps://www.healthline.com/health/glue-ear

#31 Display Patient Information Leafletshttps://www.plymouthhospitals.nhs.uk/display-pil/pil-glue-ear-8101/

#32 Glue ear in children: risk factors, symptoms and treatment | Spire Healthcarehttps://www.spirehealthcare.com/health-hub/specialties/ear-nose-and-throat/glue-ear-in-children-risk-factors-symptoms-and-treatment/

#33 Glue ear in children: risk factors, symptoms and treatment | Spire Healthcarehttps://www.spirehealthcare.com/health-hub/specialties/ear-nose-and-throat/glue-ear-in-children-risk-factors-symptoms-and-treatment/

#34 Display Patient Information Leafletshttps://www.plymouthhospitals.nhs.uk/display-pil/pil-glue-ear-8101/

#35 Glue Ear (otitis media with effusion) – Ear, Balance and Eustachian Tubehttps://earandbalance.co.uk/glue-ear-otitis-media-with-effusion/

#36 Otitis Media with Effusion (Glue Ear) | Doctorhttps://patient.info/doctor/otitis-media-with-effusion

#37 Glue Ear (otitis media with effusion) – Ear, Balance and Eustachian Tubehttps://earandbalance.co.uk/glue-ear-otitis-media-with-effusion/

#38 Glue Ear (Otitis Media with Effusion): Symptoms & Causeshttps://my.clevelandclinic.org/health/diseases/23523-glue-ear

#39 Glue Ear: Symptoms, Causes, Treatment, and Preventionhttps://www.healthline.com/health/glue-ear

#40 What is the best treatment for glue ear? | Sri Ramakrishna Hospitalhttps://www.sriramakrishnahospital.com/blog/ent/what-is-the-best-treatment-for-glue-ear/

#41 ENTchild: glue earhttps://www.entchild.com/glue-ear

#42 Otitis Media with Effusion (Glue Ear) | Doctorhttps://patient.info/doctor/otitis-media-with-effusion

#43 TREATMENT FOR GLUE EAR.logo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-bhttps://www.jwatch.org/jw199007200000005/1990/07/20/treatment-glue-ear

#44 Ear Infections and âGlue Earâ: Healthy Ears, Happy Child – Adelaide ENT SpecialistsAdelaide ENT Specialistshttps://www.adelaideentspecialists.com.au/2015/12/ear-infections-and-glue-ear-healthy-ears-happy-child/

#45 Glue Ear (Otitis Media with Effusion): Symptoms & Causeshttps://my.clevelandclinic.org/health/diseases/23523-glue-ear

#46 Glue Ear: Causes, Symptoms, and Treatmenthttps://patient.info/ears-nose-throat-mouth/hearing-problems/glue-ear

#47 How to treat temporary deafness caused by glue ear | Glue earhttps://www.ndcs.org.uk/information-and-support/childhood-deafness/causes-of-deafness/glue-ear/treat-glue-ear/

#48 Glue ear treatmenthttps://verifiedhearing.com/glue-ear-treatment/

#49https://www.oticonmedical.com/uk/info/glue-ear

#50 Glue ear – Alder Hey Children’s Hospital Trust Glue earhttps://www.alderhey.nhs.uk/conditions/patient-information-leaflets/glue-ear/

#51 Otitis Media with Effusion (Glue Ear) | Doctorhttps://patient.info/doctor/otitis-media-with-effusion

#52 Otitis Media with Effusion (Glue Ear) | Doctorhttps://patient.info/doctor/otitis-media-with-effusion

#53 Treatment of glue ear with grommets | Great Ormond Street Hospitalhttps://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/treatment-glue-ear-grommets/

#54 Glue Ear: Symptoms, Causes, Treatment, and Preventionhttps://www.healthline.com/health/glue-ear

#55 Glue Ear in Adultshttps://www.gluear.co.uk/glue-ear-in-adults/

#56 Glue Ear in Adultshttps://www.gluear.co.uk/glue-ear-in-adults/

#57https://www.bootshearingcare.com/conditions/glue-ear/

#58 Glue ear – RNIDhttps://rnid.org.uk/information-and-support/ear-health/common-ear-conditions/glue-ear/

#59 Operations for glue ear | LittleEarshttps://www.littleears.soton.ac.uk/operations-glue-ear

#60 TREATMENT FOR GLUE EAR.logo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-bhttps://www.jwatch.org/jw199007200000005/1990/07/20/treatment-glue-ear

#61 Operations for glue ear | LittleEarshttps://www.littleears.soton.ac.uk/operations-glue-ear

#62 OME | aarontrinidadehttps://www.aarontrinidade.com/ome

#63 OME | aarontrinidadehttps://www.aarontrinidade.com/ome

Ucho kleiste (otitis media z efuzją)
Leczenie

#1 Glue Ear (Otitis Media with Effusion): Symptoms & Causes
https://my.clevelandclinic.org/health/diseases/23523-glue-ear

#2 Treatment of glue ear with grommets | Great Ormond Street Hospital
https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/treatment-glue-ear-grommets/

#3 Glue Ear (Otitis Media with Effusion): Symptoms & Causes
https://my.clevelandclinic.org/health/diseases/23523-glue-ear

#4 Otitis Media in Adults | Balloon Treatment for Glue Ear in Adults
https://www.otovent.co.uk/what-is-otovent-for/glue-ear-in-adults/

#5 Glue Ear: Causes, Symptoms, and Treatment
https://patient.info/ears-nose-throat-mouth/hearing-problems/glue-ear

#6 Glue ear (otitis media with effusion) | healthdirect
https://www.healthdirect.gov.au/glue-ear

#7 Ear infections and glue ear
https://www.rch.org.au/kidsinfo/fact_sheets/ear_infections_and_otitis_media/

#8 Glue ear | Healthify
https://healthify.nz/health-a-z/g/glue-ear

#9 Glue Ear: Symptoms, Causes, Treatment, and Prevention
https://www.healthline.com/health/glue-ear

#10 Glue ear treatment
https://verifiedhearing.com/glue-ear-treatment/

#11 Treat glue earwith OtoventÂ®
https://otovent.com/

#12
https://www.racgp.org.au/clinical-resources/clinical-guidelines/handi/handi-interventions/procedures/autoinflation-for-glue-ear-in-children

#13
https://www.racgp.org.au/clinical-resources/clinical-guidelines/handi/handi-interventions/procedures/autoinflation-for-glue-ear-in-children

#14 Blowing up a balloon with the nose helps restore hearing in children with glue ear
https://evidence.nihr.ac.uk/alert/blowing-up-a-balloon-with-the-nose-helps-restore-hearing-in-children-with-glue-ear/

#15 Glue ear balloon treatment avoids surgery – myDr.com.au
https://mydr.com.au/kids-teens-health/glue-ear-balloon-treatment-avoids-surgery/

#16 Otitis Media in Adults | Balloon Treatment for Glue Ear in Adults
https://www.otovent.co.uk/what-is-otovent-for/glue-ear-in-adults/

#17 Glue Ear in Adults
https://www.gluear.co.uk/glue-ear-in-adults/

#18 Glue Ear: Causes, Symptoms, and Treatment
https://patient.info/ears-nose-throat-mouth/hearing-problems/glue-ear

#19 Glue Ear (Otitis Media with Effusion): Symptoms & Causes
https://my.clevelandclinic.org/health/diseases/23523-glue-ear

#20 Ear infections and glue ear
https://www.rch.org.au/kidsinfo/fact_sheets/ear_infections_and_otitis_media/

#21 Glue ear (otitis media with effusion) | healthdirect
https://www.healthdirect.gov.au/glue-ear

#22 Glue Ear – Otitis Media with Effusion (OME)
https://www.entuk.org/patients/conditions/4/glue_ear_otitis_media_with_effusion_ome/

#23 Otitis Media with Effusion (Glue Ear) | Doctor
https://patient.info/doctor/otitis-media-with-effusion

#24 S-carboxymethylcysteine in the treatment of glue ear: quantitative systematic review
https://pmc.ncbi.nlm.nih.gov/articles/PMC57002/

#25 S-carboxymethylcysteine in the treatment of glue ear: quantitative systematic review
https://pmc.ncbi.nlm.nih.gov/articles/PMC57002/

#26 Otitis Media in Adults | Balloon Treatment for Glue Ear in Adults
https://www.otovent.co.uk/what-is-otovent-for/glue-ear-in-adults/

#27 How to treat temporary deafness caused by glue ear | Glue ear
https://www.ndcs.org.uk/information-and-support/childhood-deafness/causes-of-deafness/glue-ear/treat-glue-ear/

#28 Treatment of glue ear with grommets | Great Ormond Street Hospital
https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/treatment-glue-ear-grommets/

#29 Glue ear (otitis media with effusion) | healthdirect
https://www.healthdirect.gov.au/glue-ear

#30 Glue Ear: Symptoms, Causes, Treatment, and Prevention
https://www.healthline.com/health/glue-ear

#31 Display Patient Information Leaflets
https://www.plymouthhospitals.nhs.uk/display-pil/pil-glue-ear-8101/

#32 Glue ear in children: risk factors, symptoms and treatment | Spire Healthcare
https://www.spirehealthcare.com/health-hub/specialties/ear-nose-and-throat/glue-ear-in-children-risk-factors-symptoms-and-treatment/

#33 Glue ear in children: risk factors, symptoms and treatment | Spire Healthcare
https://www.spirehealthcare.com/health-hub/specialties/ear-nose-and-throat/glue-ear-in-children-risk-factors-symptoms-and-treatment/

#34 Display Patient Information Leaflets
https://www.plymouthhospitals.nhs.uk/display-pil/pil-glue-ear-8101/

#35 Glue Ear (otitis media with effusion) – Ear, Balance and Eustachian Tube
https://earandbalance.co.uk/glue-ear-otitis-media-with-effusion/

#36 Otitis Media with Effusion (Glue Ear) | Doctor
https://patient.info/doctor/otitis-media-with-effusion

#37 Glue Ear (otitis media with effusion) – Ear, Balance and Eustachian Tube
https://earandbalance.co.uk/glue-ear-otitis-media-with-effusion/

#38 Glue Ear (Otitis Media with Effusion): Symptoms & Causes
https://my.clevelandclinic.org/health/diseases/23523-glue-ear

#39 Glue Ear: Symptoms, Causes, Treatment, and Prevention
https://www.healthline.com/health/glue-ear

#40 What is the best treatment for glue ear? | Sri Ramakrishna Hospital
https://www.sriramakrishnahospital.com/blog/ent/what-is-the-best-treatment-for-glue-ear/

#41 ENTchild: glue ear
https://www.entchild.com/glue-ear

#42 Otitis Media with Effusion (Glue Ear) | Doctor
https://patient.info/doctor/otitis-media-with-effusion

#43 TREATMENT FOR GLUE EAR.logo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b
https://www.jwatch.org/jw199007200000005/1990/07/20/treatment-glue-ear

#44 Ear Infections and âGlue Earâ: Healthy Ears, Happy Child – Adelaide ENT SpecialistsAdelaide ENT Specialists
https://www.adelaideentspecialists.com.au/2015/12/ear-infections-and-glue-ear-healthy-ears-happy-child/

#45 Glue Ear (Otitis Media with Effusion): Symptoms & Causes
https://my.clevelandclinic.org/health/diseases/23523-glue-ear

#46 Glue Ear: Causes, Symptoms, and Treatment
https://patient.info/ears-nose-throat-mouth/hearing-problems/glue-ear

#47 How to treat temporary deafness caused by glue ear | Glue ear
https://www.ndcs.org.uk/information-and-support/childhood-deafness/causes-of-deafness/glue-ear/treat-glue-ear/

#48 Glue ear treatment
https://verifiedhearing.com/glue-ear-treatment/

#49
https://www.oticonmedical.com/uk/info/glue-ear

#50 Glue ear – Alder Hey Children’s Hospital Trust Glue ear
https://www.alderhey.nhs.uk/conditions/patient-information-leaflets/glue-ear/

#51 Otitis Media with Effusion (Glue Ear) | Doctor
https://patient.info/doctor/otitis-media-with-effusion

#52 Otitis Media with Effusion (Glue Ear) | Doctor
https://patient.info/doctor/otitis-media-with-effusion

#53 Treatment of glue ear with grommets | Great Ormond Street Hospital
https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/treatment-glue-ear-grommets/

#54 Glue Ear: Symptoms, Causes, Treatment, and Prevention
https://www.healthline.com/health/glue-ear

#55 Glue Ear in Adults
https://www.gluear.co.uk/glue-ear-in-adults/

#56 Glue Ear in Adults
https://www.gluear.co.uk/glue-ear-in-adults/

#57
https://www.bootshearingcare.com/conditions/glue-ear/

#58 Glue ear – RNID
https://rnid.org.uk/information-and-support/ear-health/common-ear-conditions/glue-ear/

#59 Operations for glue ear | LittleEars
https://www.littleears.soton.ac.uk/operations-glue-ear

#60 TREATMENT FOR GLUE EAR.logo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b
https://www.jwatch.org/jw199007200000005/1990/07/20/treatment-glue-ear

#61 Operations for glue ear | LittleEars
https://www.littleears.soton.ac.uk/operations-glue-ear

#62 OME | aarontrinidade
https://www.aarontrinidade.com/ome

#63 OME | aarontrinidade
https://www.aarontrinidade.com/ome

#64 Glue ear: thereâs a better alternative to grommet surgery
https://theconversation.com/glue-ear-theres-a-better-alternative-to-grommet-surgery-212660

#65 Glue ear: thereâs a better alternative to grommet surgery
https://theconversation.com/glue-ear-theres-a-better-alternative-to-grommet-surgery-212660

#66 Causes of glue ear | Information about glue ear
https://www.ndcs.org.uk/information-and-support/childhood-deafness/causes-of-deafness/glue-ear/

#67 Causes of glue ear | Information about glue ear
https://www.ndcs.org.uk/information-and-support/childhood-deafness/causes-of-deafness/glue-ear/