What is glue ear?

Glue ear is one of the most common childhood illnesses. Children under the age of five are the largest group affected, though for some it can persist into adolescence. Some adults may also be affected.

For ears to work properly the middle ear needs to be kept full of air. The eustachian tube, which usually does this, runs from the middle ear to the back of the throat. In children this tube is not as vertical and wide as it will be when they get older and as a result doesn’t work as well.

If the eustachian tube becomes blocked, air cannot enter the middle ear. When this happens, the cells lining the middle ear begin to produce fluid. This can be like a runny liquid which can get thicker as it fills the middle ear. With fluid blocking the middle ear, it becomes harder for sound to pass through to the inner ear.

This can make quieter sounds difficult to hear. It can be like listening to the world with both fingers stuck in your ears. It’s hard work, try it for yourself!

Glue ear is often, but not always, linked with ear infections. However, it can sometimes develop unnoticed.

A prolonged period of time with reduced hearing can affect the way in which a child’s speech develops. Children with glue ear may also fall behind at school and become disruptive if they do not have extra support. Changes in behaviour, becoming tired and frustrated, lack of concentration, preferring to play alone and not responding when called may indicate glue ear.

What conditions influence glue ear?

There are many different things that can contribute to glue ear. These include colds and flu, allergies and passive smoking. Children with cleft lip and palate, or with genetic conditions, such as Down’s Syndrome, may be more likely to get glue ear as they may have smaller eustachian tubes.

What treatment is available?

Glue ear tends to get better by itself, but this can take a while. If the glue ear is not causing any major problems, a period of watchful waiting for about three months is often advisable. If glue ear is causing problems with poor hearing, poor speech or lots of infections, it may be better to put grommets in (see info sheet on Grommets).

Getting your child to blow up a special balloon with his or her nose can clear fluid in their ear and improve their hearing within a few weeks. But your child has to do this regularly, and young children can find the balloon hard to use. Doctors call this method autoinflation.

Some doctors may use nose drops or nasal sprays to see if they help. The evidence for this however is limited. Antibiotics and antihistamines do not seem to help this type of ear problem. Alternative treatments, such as cranial osteopathy also do not seem to be helpful.

A hearing aid can sometimes be used to treat the poor hearing and speech problems that are caused by glue ear. This would mean that your child would not need an operation and are an option for those in whom a general anaesthetic is a significant risk.

In the meantime how can I make hearing easier for my child?

Basic communication tips can help to make listening easier for your child. It is important to get your child’s attention before you start talking. Make sure you face your child as much as possible, and keep eye contact. Check that background noise is kept to a minimum. Speak clearly, without shouting and maintain your normal rhythm of speech.

The teacher or school nurse may realise that your child is having problems, but may not be aware that this is because of their hearing. It is important that you tell the teacher about your child’s hearing so that arrangements can be made in school to help. It is important that your child is able to sit near the teacher in the classroom, that they understand what is said and that they are not made to feel awkward about asking for things to be repeated.