This book describes Glue Ear, Diagnosis and Treatment and Related Diseases

Glue ear or Otitis media with effusion (OME) is thick or sticky fluid behind the eardrum in the middle ear.
It can happen without an ear infection.
The Eustachian tube joins the inside of the ear to the back of the throat.
This tube helps drain fluid to prevent it from building up in the ear.
The fluid drains from the tube and is swallowed.
OME and ear infections are joined in two ways:
1. After most ear infections have been treated, the fluid (effusion) remains in the middle ear for a few days or weeks.
2. When the Eustachian tube is partially blocked, the fluid builds up in the middle ear.
Bacteria inside the ear become trapped and begin to grow.
This may cause an ear infection.
Causes
These disorders can cause swelling of the Eustachian tube lining that leads to more fluid:
1. Allergies
2. Irritants (mostly cigarette smoke)
3. Respiratory infections
These disorders can cause the Eustachian tube to close or become blocked:
1. Drinking while lying on the back
2. Sudden rises in air pressure (such as descending in an airplane or on a mountain road)
3. Getting water in a baby's ears will not lead to a blocked tube.
It happens most often in children under age 2 but is rare in newborns.
Younger children get OME more often than older children or adults for several reasons:
1. The tube is shorter, more horizontal, and straighter, making it easier for bacteria to enter.
2. The tube is floppier, with a tinier opening that's easy to block.
Young children develop more colds because it takes a longer time for the immune system to be able to recognize and ward off cold viruses.
The fluid in OME is often thin and watery.
In the past, it was believed that the fluid got thicker the longer it was present in the ear.
("Glue ear" is a frequent name given to OME with thick fluid.)
Symptoms
Unlike children with an ear infection, children with OME do not pretend to be sick.
OME often does not have evident symptoms.
Older children and adults often complain of muffled hearing or a sense of tightness in the ear.
The start of signs and symptoms of ear infection is normally rapid.
Children
Symptoms frequent in children are:
1. Ear pain, especially when lying down
2. Tugging or pulling at an ear
3. Difficulty sleeping
4. Crying more than usual
5. Acting more irritable than usual
6. Difficulty hearing or responding to sounds
7. Loss of balance
8. Fever of 100 F (38 C) or higher
9. Drainage of fluid from the ear
10. Headache
11. Loss of appetite
Adults
Frequent symptoms in adults are:
1. Ear pain
2. Drainage of fluid from the ear
3. Reduced hearing
Diagnosis:
The doctor can normally diagnose an ear infection based on the symptoms the patient describe and an exam.
The doctor will likely use a lighted otoscope to look at the ears, throat and nasal passage.
The doctor will examine the eardrum and look for:
1.Eardrum that does not seem to move when little puffs of air are blown at it
2.Fluid behind the eardrum
A test called tympanometry is accurate for diagnosing OME.
Treatment
Most doctors will not treat OME at first, unless there are also features of an infection.
1. Watchful waiting for 3 months from the date of effusion onset
2. Autoinflation is a method where the Eustachian tube is reopened by raising pressure in the nose.
This appears to be the best method for treating glue ear instead of antibiotics,...