Hi. Here is the introduction to a series of blogs regarding glue ear and childhood hearing loss…In this series, I will consider treatment options, shared decision making, and management strategies in children with, and without, additional needs.

Otitis Media with Effusion (OME, glue ear, serous otitis media) is the commonest cause of hearing loss in childhood. There are peaks in the incidence of OME around 3 and 5 years of age (bimodal distribution) and around 80% of children have experienced non-trivial OME by the start of adolescence. OME is more prevalent and persistent in certain conditions, including cleft lip & palate (CLP) and Down syndrome (DS).

Multiple aetiologies are associated with the development and persistence of OME and the relevant importance of individual aetiological factors and interactions between factors, is likely to vary within and between children. Eustachian tube function is considered to be central to the development and persistence of OME.

When faced with a common condition with significant potential consequences upon development, for which the cause varies between children and potentially at different time points during childhood, an individualized treatment strategy is needed. This strategy must benefit from best available evidence and shared decision making between clinician, parents and patient. Reflecting the variability in causal factors an optimum treatment for OME in childhood has remained elusive, with influencing factors including expected persistence of the underlying tendency towards the development of OME. Several interventions exist to manage persistent OME, each with an established risk profile.