Glue ear Q&As
Published by Bupa's health information team, December 2008.
Answers to questions about glue ear
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- How will I know if my child's hearing is affected?
- What kind of tests will my child have?
- Do I need to take any precautions after my child's operation for grommets?
How will I know if my child's hearing is affected?
Hearing loss is one of the few symptoms of glue ear but it can be difficult to identify. Your child may mishear what you say and have trouble hearing you in a noisy environment or when you aren't looking at them. Hearing problems can also affect behaviour and balance so your child might seem more clumsy than usual, have trouble concentrating or become frustrated or irritable.
Explanation
Hearing problems can be hard to spot, particularly if your child is very young and can't tell you that he/she is having trouble hearing. Hearing problems caused by glue ear also come and go which makes it even harder to notice any hearing loss.
A child with glue ear will find sounds muffled rather than not hearing them at all. Sometimes it might appear that your child is only hearing you when he/she wants to. You may not notice any symptoms at home, but your child's teacher, playgroup leader or nursery worker might do. Some things to look out for are described here.
- Your child may mishear what you say, particularly when you're talking and he/she isn't looking directly at you. Your child may also have trouble hearing sounds that come from outside the area they can see. Your child may often ask you to repeat what you have said or have trouble hearing in a noisy environment.
- Your child might say "what?", "eh?" or "pardon?" more than he/she usually does. Your child might need the television volume turned up.
- Because your child can't hear well he/she might start to behave differently. Children can become withdrawn or have trouble concentrating, which can lead to frustration and irritability. Once your child becomes tired this can also lead to temper tantrums and overactivity.
- Children with glue ear can seem like they are daydreaming or not paying attention either at home or at school or nursery.
- If your child is a baby or very young when he/she develops glue ear, this sometimes leads to a delay in the development of speech. For older children hearing loss can affect other language skills like reading and writing. They may also start to struggle at school.
- Inflammation in the middle ear can irritate the balance system in the inner ear. Your child might seem to be more clumsy than usual or have trouble with balance.
If you're worried that your child may have hearing loss, talk to other people who spend time with him/her to see if they have noticed any change and then see your GP for advice.
If your child is found to have glue ear and hearing problems, make sure that playgroup or nursery staff and teachers know, so that they can help your child during class. You may also find it helps to:
- speak to your child face to face and at his/her level
- get your child's attention before you start talking to him/her - call your child's name or use touch
- speak clearly with a normal volume and rhythm - don't shout
- cut down background noise as much as possible, for example turn off the television
- be direct and simple in what you say and check that your child understands what you have said
- if your child has a close friend, you may want to tell his/her parents about the glue ear
Further information
- British Tinnitus Association
www.tinnitus.org.uk - Deafness Research UK
www.deafnessresearch.org.uk - Royal National Institute for Deaf People
www.rnid.org.uk
Sources
- Surgical management of children with otitis media with effusion. National Institute for Health and Clinical Excellence (NICE), 2008. www.nice.org.uk
- Glue ear. Royal National Institute for Deaf People. www.rnid.org.uk, accessed 20 July 2008
- Glue ear - facts for parents. Deafness Research UK. www.deafnessresearch.org.uk, accessed 20 July 2008
- Glue ear. British Tinnitus Association. www.tinnitus.org.uk, accessed 20 July 2008
- Diagnosis and management of childhood otitis media in primary care. Scottish Intercollegiate Guidelines Network (SIGN), 2003. www.sign.ac.uk, accessed 20 July 2008
What kind of tests will my child have?
Audiometry, tympanometry and otoscopy are the main tests used to find out if your child has glue ear and if his/her hearing is affected. Audiometry tests your child's hearing using sounds of different volumes and tones. Tympanometry tests how flexible the eardrum is, which can help to diagnose glue ear. Otoscopy tests to see if your child has any fluid behind his/her eardrums.
Explanation
There are two main tests used to find out if a child has glue ear and if the glue ear is affecting his/her hearing. These are audiometry and typanometry. Both of these tests are usually done by an audiologist - a technician or scientist who specialises in identifying and treating hearing and balance problems. Your GP can refer you to a community paediatric audiology clinic at your local hospital for these tests.
Tympanometry is a test to find out how well your child's eardrum is working. A healthy eardrum is flexible and allows sound to pass through it and into your middle and inner ear. If your child has glue ear, his/her eardrum stiffens up because of the fluid behind it. Sound bounces off it rather than passing through. The stiffness can be measured and can show whether or not your child has glue ear. Other conditions, such as problems with the middle ear bones, can also cause a stiff eardrum.
The test is painless and takes just a few minutes to do. Tympanometry can be done with babies and young children because it doesn't test hearing and doesn't rely on getting a reaction from your child. A small earpiece with a soft rubber tip is placed just inside your child's ear. A pump then causes the pressure in the ear to change and measures the amount of sound bounced back. The results show up straight away.
Audiometry tests your child's hearing. There are a number of different ways of doing an audiometric test depending on how old your child is. All of the tests are looking to see your child's reaction to sounds that have different volumes and pitch.
If your child is old enough to go to school, during the test he/she will usually be asked to wear head- or earphones and press a button when he/she hears a sound. If your child is younger, the test is likely to be done as part of a game. Your child might be asked to put a peg on a board when he/she hears a sound. Children between six months old and about two and a half may be tested using something called visual reinforcement audiometry (VRA). Different sounds will be played and when your child hears them he/she will turn towards the sound. As your child does this he/she will be given a reward, for example the toy will light up. The tester can gradually turn down the volume of the sound to find out the quietest sound your child can hear.
Further information
- Deafness Research UK
www.deafnessresearch.org.uk - National Deaf Children's Society
www.ndcs.org.uk
Sources
- Glue ear - facts for parents. Deafness Research UK. www.deafnessresearch.org.uk, accessed 20 July 2008
- Surgical management of children with otitis media with effusion. National Institute for Health and Clinical Excellence (NICE), 2008. www.nice.org.uk
- Diagnosis and management of childhood otitis media in primary care. Scottish Intercollegiate Guidelines Network (SIGN), 2003. www.sign.ac.uk
- 18 week commissioning pathway - glue ear in children. Department of Health. www.dh.gov.uk, accessed 24 September 2008
- Understanding deafness. National Deaf Children's Society. www.ndcs.org.uk, accessed 20 July 2008
Do I need to take any precautions after my child's operation for grommets?
Recovery from an operation to have grommets put in is usually straightforward and most children have no problems. Your child should wear earplugs when having a bath or shower or when washing his/her hair.
Explanation
The hole made in your child's eardrum when grommets are put in is very small so it's uncommon for infection to develop or for your child to have problems with usual day-to-day activities. If your child's hearing problems were caused by glue ear, his/her hearing should return to normal straight after grommets are put in. Some children think that everything sounds very loud for a while. It will probably take a few days for sounds to seem at their usual level again.
It's safe for your child to go swimming a couple of weeks after a grommet operation but he/she should only swim on the surface of the water. Your child shouldn't dive or swim underwater. When your child is swimming he/she shouldn't need to wear earplugs. You should take care not to get soapy or dirty water into your child's ears and be aware that swimming pools may not always be clean.
Use earplugs when you wash your child's hair or when he/she has a bath or shower. You can make your own waterproof earplugs by covering cotton wool with petroleum jelly. You can also buy earplugs from your chemist or some audiology clinics can make individual ones for your child. You will need to take these precautions until the grommets have fallen out. This usually takes between nine and 18 months.
About one in 20 children develops an infection after a grommet operation. Infections after grommets aren't usually painful and your child may not seem ill, but if you see a yellowish liquid coming out of your child's ear, see your GP for advice. Your GP may prescribe antibiotic ear drops for your child.
It's safe for your child to fly after surgery for grommets. Having grommets put in actually helps air to move in and out of the ear more easily, which reduces stress on your child's eardrum. This helps to prevent pain during changes in air pressure, such as when taking off or landing.
In general, recovery from an operation to have grommets put in is straightforward. Sometimes when the grommet comes out a small hole is left in the eardrum but usually this closes up in time, especially if it was the first time grommets were put in. Your child might also have some scarring on his/her eardrum but this won't usually affect hearing.
Further information
- Royal National Institute for Deaf People
www.rnid.org.uk
Sources
- Glue ear. Royal National Institute for Deaf People. www.rnid.org.uk , accessed 20 July 2008
- Grommets. ENT UK. www.entuk.org, accessed 20 July 2008
- Diagnosis and management of childhood otitis media in primary care. Scottish Intercollegiate Guidelines Network (SIGN), 2003. www.sign.ac.uk
- Glue ear. British Tinnitus Association. www.tinnitus.org.uk, accessed 20 July 2008
Related topics
This 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: December 2008
Glue ear factsheet
Visit the glue ear health factsheet for more information.
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