Glue Ear

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Glue ear is a condition where the middle ear fills with glue-like fluid instead of air. This causes dulled hearing. In most cases it clears without any treatment. An operation to clear the fluid and to insert ventilation tubes (grommets) may be advised if glue ear persists.

Glue ear means that the middle ear is filled with fluid that looks like glue. It can affect one or both ears. The fluid dampens the vibrations of the eardrum and tiny bones (ossicles) created by sound. The cochlea receives dampened vibrations and so the volume of the hearing is turned down. Glue ear usually occurs in young children but it can develop at any age. Glue ear is sometimes called otitis media with effusion (OME).

What causes glue ear?
The cause is probably due to the Eustachian tube not working properly. The balance of fluid and air in the middle ear may become altered if the Eustachian tube is narrow, blocked, or does not open properly. Air in the middle ear may gradually pass into the nearby cells if it is not replaced by air coming up the Eustachian tube. A vacuum may then develop in the middle ear. This may cause fluid to seep into the middle ear from the nearby cells.

Some children develop glue ear after a cough, cold, or ear infection when extra mucus is made. The mucus may build up in the middle ear and not drain well down the Eustachian tube. However, in many cases glue ear does not begin with an ear infection.

How common is glue ear?
Glue ear is common. By 10 years of age, 8 out of 10 children will have had at least one episode of OME. It is most common between the ages of 1 and 6. Boys are more commonly affected than girls. Most cases occur in winter. It is more common in children who:

Are in daycare.
Have an older brother or sister.
Live in homes where people smoke.

What are the symptoms of glue ear?
Dulled hearing
This is the main symptom. Your child’s hearing does not go completely and the hearing loss is often mild. However, the severity of hearing loss varies from child to child, is sometimes quite severe and can vary from day to day in the same child. Hearing varies according to the thickness of the fluid and other factors. For example, it is often worse during colds. Older children may say if their hearing is dulled. However, you may not notice dulled hearing if your child is younger, particularly if only one ear is affected. You may find that your child turns the TV or radio up loud, or often says “what” or “pardon” when you talk to them. Babies may appear less responsive to normal sounds.

Pain
This is not usually a main symptom but mild earache may occur from time to time. Children and babies may pull at their ears if they have mild pain. However, the gluey fluid is a good food for germs (bacteria) and ear infections are more common in children with glue ear. This may then cause bad earache for the duration of an infection. Always have some painkiller in your home in case earache develops.

Development and behaviour may be affected in a small number of cases
If dulled hearing is not noticed then children may not learn so well at school if they cannot hear the teacher. Your child may also become frustrated if they cannot follow what is going on. They may feel left out of some activities. They can become quiet and withdrawn if they cannot hear so well.

There has been concern that dulled hearing from glue ear may cause problems with speech and language development. This in turn was thought perhaps to lead to poor school achievement and behavioural problems. However, research studies that have looked at this issue are reassuring. The studies showed that, on average, children with glue ear had no more chance (or just a little more chance) of having long-term behavioural problems or poor school performance compared with children without glue ear. However, these studies looked at the overall average picture. There is still a concern that the development of some children with glue ear may be affected – in particular, some children with untreated severe and persistent glue ear.

So, in short, developmental delay including speech and language is unlikely to occur in most children with glue ear. However, if you have any concern about your child’s development, you should tell a doctor.

Research has also detected a link between glue ear and attention deficit hyperactivity disorder (ADHD) as well as anxiety and depression.

How does glue ear progress?
The outlook is usually good. Many children only have symptoms for a short time. The fluid often drains away gradually, air returns and hearing then returns to normal.

Hearing is back to normal within three months in about 5 in 10 cases.
Hearing is back to normal within a year in more than 9 in 10 cases.
Glue ear persists for a year or more in a small number of cases.
Some children have several episodes of glue ear which cause short but repeated (recurring) episodes of reduced hearing. The total time of reduced hearing in childhood may then add up to many months.