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Glue earPublished by BUPA's health information team, healthinfo@bupa.com, February 2008. This factsheet is for parents of children with glue ear, or who would like information about it. Glue ear is very common in children - approximately four out of five will have had this infection at least once by the time they are four years old. The medical name for glue ear is otitis media with effusion. If your child has glue ear, it means there is a build-up of fluid in the middle ear. Most children get better within six weeks if it's related to a cold, or a few months to a year without any treatment. Some children may need treatment including surgery.
Glue ear animation The middle earThe middle ear is behind your eardrum. It contains three tiny bones that move when sounds reach them. These transmit sound waves through your middle ear to your inner ear. Usually, your middle ear is filled with air but if you have inflammation, fluid and mucus can build up there. The eustachian tube connects your middle ear with your throat.
About glue earGlue ear is a condition that occurs when fluid and mucus collect in the middle ear behind the ear drum. This happens if you have an infection or other condition that causes inflammation there. Your child can get glue ear if the eustachian tube becomes blocked and fluid can't drain from the middle ear. A blocked eustachian tube can also stop air from getting into the middle ear. This affects the pressure inside your child's ear and pulls the ear drum inwards. A sticky fluid builds up inside the middle ear and affects hearing, since the middle ear is filled with liquid rather than air. SymptomsUnlike a middle ear infection (otitis media) where there is earache and signs of infection, your child won't necessarily have any symptoms if he or she has glue ear. The main indication is hearing loss and a feeling of the ear being "bunged up". If your child has glue ear, he or she may have problems paying attention or interacting with others, as well as with their speech and language as a result of not being able to hear properly. Your child may also appear clumsy and have trouble with his or her balance. CausesChildren, particularly boys, are most at risk of glue ear because their eustachian tubes are shorter and more horizontal. This means that they get blocked more easily. Over half of all children with glue ear get it as a result of inflammation of the middle ear (acute otitis media). If your child has nasal allergies to pets or dust, or has hay fever, he or she may be more likely to develop glue ear. Inflammation caused by the allergic reaction may cause their eustachian tube to swell and become blocked more easily. This may be the cause of glue ear if your child keeps getting it, even after they have had treatment. Glue ear may also be caused by enlarged adenoids - these are two lumps of tissue at the back of the nose where it meets the throat. They help to fight infections but if your child's adenoids become enlarged, they can block the eustachian tube. Other reasons why your child may be more likely to develop glue ear include:
Your child is also at an increased risk if they have a lot of contact with other children, for example if they go to nursery or playschool. In addition, children who are born with a cleft lip or palate, or who have Down's syndrome are more susceptible to the condition. DiagnosisYour GP will ask about your child's symptoms and medical history. He or she will use an instrument called an otoscope to look at your child's ear drum. A healthy ear drum is pink but if your child has glue ear, it may be yellow or grey. It may also look as if it's being pulled inwards and not move as much as it usually would. TreatmentBetween half and three-quarters of children with glue ear get better within three months without any treatment. Out of 100 children, only five will still have glue ear after a year. This condition mainly occurs in children and usually gets better on its own as your child grows up. It's a good idea to keep an eye on your child's educational, behavioural and social progress as these may be affected by the temporary deafness. Their speech and language development may also be delayed, therefore it's important to see your GP if you think your child has glue ear. After three months, if the condition isn't improving, your GP may refer you to an otolaryngologist (a doctor specialising in conditions affecting the ear, nose and throat) or an audiological paediatrician (a doctor specialising in conditions affecting children's hearing). He or she may also suggest that your child has a hearing test. It's not recommended that your child takes antibiotics, antihistamines or decongestants for glue ear as they don't have any significant effect. There is also the possibility that your child may have side-effects as a result of taking antibiotics. Non-surgical treatmentsIf you decide not to go ahead with surgery, it's important that your child has regular hearing checks. Watch out for developmental problems that may be linked to hearing loss. A hearing aid may be useful for treating the hearing loss and speech problems that glue ear can cause. There is some evidence that a technique called autoinflation may help children with glue ear. Your child uses his or her nose to inflate a balloon. This puts pressure on the nose and may help to open up the eustachian tube. This aims to let air into the middle ear so the fluid there can drain out. Some studies have shown this technique to be helpful in the short-term, but more research is needed into the long-term effects. Your GP will be able to give you more information about the treatment options that are available. SurgeryIf your child is getting lots of ear infections or if he or she has serious hearing loss, your doctor may suggest surgery. He or she may also recommend this if there has been damage to your child's middle ear or ear drum. Surgery may involve a procedure called a myringotomy in which a small cut is made in your child's ear drum so that fluid can drain out. Grommets may also be inserted into your child's ear. These are small plastic tubes which are placed in a cut made in your child's ear drum. Grommets allow air to get in and out of the ear and usually mean that your child can hear better. They can be effective at improving hearing for up to two years but don't appear to offer any benefit in the long term. Grommets usually fall out after about six months to a year. Half of all children who have grommets inserted need to have another set put in after the first ones fall out. If your child has grommets, it's fine for him or her to go swimming and take showers and baths as usual, although diving isn't recommended. You may wish to try using cotton wool coated in petroleum jelly as an earplug. It may help your child if they have an operation to remove their adenoids. This is called an adenoidectomy. However, the operation doesn't seem to improve hearing unless grommets are also inserted. As with all surgery, there are some risks involved with inserting grommets or having an adenoidectomy. These include infection or, with grommets, the possibility of permanent damage to your child's ear drum. Further information
Sources
Related topicsThis information was published by BUPA's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by BUPA doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: February 2008. Expected review date: February 2010.
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