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Chronic Middle Ear Fluid
Normal hearing requires air on either side of an intact eardrum (tympanic membrane). Allergies, infections, or undetermined factors can cause a chronic condition in which the middle ear fills with fluid. As the fluid remains in place, the middle ear lining removes water from it producing a thick mucous that may reach the point of a "glue ear". While a child may respond to sounds normally with fluid in the middle ear, the high frequency sounds are filtered producing a distorted signal as the sound reaches the brain. Children will reproduce what they hear with their own speech. Consequently, chronic middle ear fluid may produce speech abnormalities.
Recent information makes it clear that a clear middle ear is necessary for the brain to develop understanding of spoken language in background noise. An abnormality of this brain function is known as a Central Auditory Processing Disorder. In the first twelve years of life, this system is developing actively and steadily. A normal system is critical to hearing in noise such as classroom performance or the workplace.
It is normal for fluid to remain for up to several weeks following an ear infection. If fluid persists longer than 3 months, however, it is unlikely to clear without intervention. Medical treatment aimed at fluid alleviation is frequently first line therapy. Fluid that will not clear is treated with tympanostomy tubes which results in rapid return of the ear to normal status. In most situations, the fluid does not recur after the tubes extrudes from the ear or is removed.