Glue ear
Your health expert: Mr Anil Banerjee, Ear, Nose and Throat Consultant
Content editor review by Pippa Coulter, November 2021
Next review due November 2024
Glue ear is a build-up of fluid in your middle ear that can cause problems with hearing. It’s common in children, but adults can get it too. It usually goes away on its own without treatment. But sometimes you may need an operation to put tubes called grommets in your ear.
How glue ear develops
Glue ear | Watch in 2:02 minutes
This animation explains what glue ear is. Glue ear is most common in children.
This animation explains what glue ear is.
Glue ear is most common in children.
To understand the cause of glue ear, it's helpful to know how the ear works.
Your ear consists of three parts: the outer ear, the middle ear and the inner ear.
These all work together to pass the sound from your ear to your brain.
Here in the animation, we show how the sound waves pass through your ear.
First, the sound waves pass through your ear canal, to your eardrum.
Your eustachian tube controls the pressure in your middle ear, to make sure that your eardrum can vibrate properly.
Your ossicles amplify the sound, which then passes through a small window into your cochlea.
In the cochlea, the sound waves are converted into electrical signals that travel to your brain.
Sometimes, the eustachian tube becomes blocked.
This may happen because of an infection or an allergy.
It's most common in children.
A blocked eustachian tube can cause fluid to build up in the middle ear.
This is often known as 'glue ear' because sometimes the fluid is sticky like glue.
The fluid makes it much more difficult for the sound waves to pass through your ear canal.
It also prevents the eardrum and ossicles from vibrating properly.
So, a child with glue ear may have some hearing loss.
Glue ear will usually get better on its own.
If it doesn't, your doctor will advise you on the best treatment for your child.
This is the end of the animation.
About glue ear
Glue ear is very common in children. It’s most common between the ages of six months and four years. Most children will have had an episode of glue ear by the time they start school. Adults can also get glue ear, though it’s much less common than in children.
In glue ear, fluid collects inside your middle ear. Your middle ear is normally kept ventilated (filled with air) by a tube running between your middle ear and the back of your throat. This is called the eustachian tube. Glue ear can happen if this tube becomes blocked or inflamed, and fluid can’t be cleared from inside your middle ear. The fluid inside your ear can affect your hearing.
Glue ear usually gets better over a few months. Most children who get it will no longer have it after a year. For a few children though, it carries on longer and can cause hearing loss. This can affect their education, language development and behaviour.
Causes of glue ear
Doctors aren’t completely sure why glue ear happens. But more than a half of the time, glue ear follows a middle ear infection – especially in young children. It’s more common during the winter months.
Other possible causes include:
- problems with the Eustachian tube – the tube between the middle ear and the back of the throat
- an infection (a virus or bacteria)
- inflamed middle ear
- infected or enlarged adenoids
Your child is more likely to get glue ear if they:
- live with someone who smokes
- have repeated colds and throat infections
- have allergies
- are bottle fed with unventilated bottles
- have contact with lots of other children, such as at a nursery
- have a cleft palate or Down’s syndrome
Symptoms of glue ear
The most common symptom of glue ear is hearing loss. This can be easily missed in very young children and babies. If your child has hearing loss caused by glue ear, you might notice some of the following signs.
- Mishearing what you say.
- Asking for things to be repeated.
- Not responding when you call or talk to them, especially from behind.
- Not being able to hear or communicate well in a group.
- Having the television volume up high.
- Having trouble concentrating.
- A change in behaviour.
Other symptoms that can affect both adults and children include a feeling of fullness inside your ear, mild earache and hearing ‘popping’ in your ear. You or your child may have problems with balance too.
If a child’s hearing loss is severe, or they’ve had it for a while, they may have problems with speech and language. Their listening skills can also be affected and these things together can affect their progress at nursery or school.
Contact a GP if you notice these symptoms yourself, or in your child. You wouldn’t usually have discharge from your ear with glue ear. Contact a doctor straightaway if you have this symptom.
Diagnosis of glue ear
If you see a GP, they’ll ask about you, or your child’s symptoms and medical history. They will look at your eardrum (or your child’s) using a device called an otoscope.
The GP may arrange a hearing test. There are two main types of hearing test. Tympanometry assesses how well their eardrum reacts to sound and audiometry tests their hearing.
If your child has glue ear, the GP may suggest just monitoring them for three months, as it often clears up on its own. If after three months your child’s symptoms haven’t got any better, the GP may refer them to an ear, nose and throat (ENT) specialist. If your child has Down’s syndrome or a cleft palate, they’re likely to be referred to a specialist straightaway.
If you have glue ear as an adult, your GP may refer you to an ENT specialist, depending on your symptoms and history. They may want to run some tests to check whether there’s an underlying reason for your glue ear.
Self-help
If your child has hearing loss due to glue ear, there are lots of things you can do to help them. Try to:
- get your child’s attention before you talk to them
- speak to your child clearly, slowly and face-to-face
- cut down background noise such as music or TV
- read with your child every day to help develop language skills
- work with your child’s nursery or school to make sure they get the right support
Treatment of glue ear
In children, glue ear usually gets better on its own with no treatment. The GP will usually monitor your child for three months to see whether the glue ear goes by itself, before considering treatment.
Glue ear in adults also usually clears up on its own. Your GP may refer you to a specialist for further investigation and treatment if it doesn’t.
There’s no evidence that medicines, such as antibiotics, antihistamines, mucolytics, steroids and decongestants are helpful. There is also no evidence that complementary therapies, such as homeopathy, acupuncture, cranial osteopathy and special diets will help.
Non-surgical treatments
Hearing aids
If your child has hearing loss in both ears, they may be offered hearing aids while they’re waiting for surgery, or as an alternative to surgery. This might be an option if your child is unable to have surgery for some reason, or if you’d prefer them not to. Your child can wear them until the glue ear clears up on its own, or until they have surgery.
Autoinflation
Your doctor may suggest a technique called autoinflation that may help your child with their symptoms. They may be able to do this while they’re waiting to see if their glue ear clears up, or while they’re waiting for surgery.
In autoinflation, your child blows up a balloon using a nose-piece attached to one nostril. They close their mouth and the other nostril. This can help to open their eustachian tube and let air into the middle ear so that fluid can drain out.
Older children may be able to do this without using the balloon, by pinching their nostrils and closing their mouth while they forcibly blow out. Check with your doctor whether they think this would be helpful for your child. You should never do it if your child has a cold or other virus.
Surgery
Grommets
Surgery for glue ear involves placing tiny plastic tubes called grommets into your ear drum. These help drain out fluid from your middle ear. Your doctor may offer your child surgery if their glue ear is no better after three months and they have severe hearing loss in both ears. Surgery may also be an option if your child’s learning or development is significantly affected.
You can have grommets as an adult too, depending on what’s caused your glue ear.
Grommets are usually put in with a general anaesthetic, which means you, or your child will be asleep during the procedure. Your surgeon makes a tiny cut in your ear drum and drains away the fluid in your middle ear, before putting in the grommets. Grommets can improve hearing while they’re in, but eventually they fall out as your eardrum heals. You or your child may need more grommets put in if the glue ear comes back.
Adenoid removal
Sometimes surgeons recommend that children have their adenoids out (an adenoidectomy) at the same time as having grommets put in. The adenoids are lumps of soft tissue at the back of your child’s nose. Sometimes the adenoids getting infected is what causes glue ear. Your surgeon will usually only suggest taking them out if your child also has lots of coughs, colds and sore throats. It can improve how well the grommets work.
Living with grommets
You’ll usually need to keep your (or your child’s) ears dry for a few weeks after the operation. This helps to stop water getting into the ear and causing an infection while it’s healing. After the first few weeks, you’ll usually be able to swim or bathe as normal. There’s no evidence that wearing earplugs or a swimming cap will make any difference to your likelihood of getting an infection. It may be best to avoid diving though.
It’s fine to fly if you have grommets.
If you have any discharge from your ear while you have grommets, see a doctor. You may have an infection which will need treatment.
Adults can get glue ear, although it’s far less common in adults than it is in children. If you have glue ear as an adult, you may see a specialist to check whether there’s an underlying reason for it. You can have grommets for glue ear as an adult, just as you would for a child.
Acute middle ear infection in children
If you’re a parent you’ll probably know that middle ear infections are common in children, and unfortunately they’re often painful.
Fever in children
If your child’s temperature is 38°C (100.4°F) or above, then it means they have a fever.
Adenoid and tonsil removal
Adenoid and tonsil removal is a procedure that involves taking away small lumps of tissue at the back of your nose and throat.
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