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Glue ear


Expert reviewer, Mr Anil Banerjee, Ear, Nose and Throat Consultant
Next review due May 2022

Glue ear is a build-up of fluid in your middle ear that can cause problems with hearing. It’s common in children. It usually lasts for a few months and then gets better on its own without treatment. If this doesn’t happen, and you or your child develops severe hearing problems, then an operation may help.

About glue ear

Around eight out of 10 children have glue ear at least once by the time they reach the age of 10. Your child is most likely to get it between the ages of two and five. They’re more likely to get it during the winter months and it often comes and goes.

When the tube between your middle ear and the back of your throat, the Eustachian tube, becomes blocked, air can’t get in and it starts to fill with fluid. This makes it harder for sounds to pass through the middle ear to the inner ear, which is what affects your child’s hearing.

Glue ear usually gets better over a few months and most children will no longer have it after a year. For a few children it carries on longer and can cause hearing loss, which can affect their education, language development and behaviour.

Glue ear in adults

Adults can get glue ear, though it’s much less common than in children. Treatment is generally the same as for children. You’re likely to notice some hearing loss, but may also hear popping sounds.

If you think you may have glue ear as an adult, get it checked out by your GP.

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Symptoms of glue ear

Sometimes the symptoms of glue ear can be hard to spot, especially if your child is very young. The most common symptom is hearing loss. You might see this as some of the following behaviour.

  • Mishearing what you say.
  • Not responding when you talk to them, especially from behind.
  • Having the television volume up high.
  • Having trouble concentrating.
  • Preferring to play on their own, rather than in a group.
  • Becoming tired.
  • A change in behaviour.

Other symptoms include feeling like the inside of the ear is blocked, mild ear pain and hearing ‘popping’ in the ear. Some children have repeated ear infections, coughs and colds before they get glue ear.

If hearing loss is severe, or it’s been a symptom for a while, your child 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.

Diagnosis of glue ear

Your GP will ask about your child’s symptoms and medical history. They will look at your child’s eardrum using an otoscope. This is a small, hand-held device, which has a magnifying glass and a light.

Your GP may arrange for your child to have a hearing test, followed by monitoring for three months and then another hearing test. There are two main types of hearing test. Tympanometry assesses how well their eardrum reacts to sound and audiometry tests their hearing. The type of test your child has will depend on how old they are and their stage of development.

If after three months your child’s symptoms haven’t got any better, your 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.

Self-help

There are lots of things you can do to help your child. If you smoke, then your child is more likely to develop glue ear so now is a good time to stop or to smoke outside, well away from your children. You may also find it helps to:

  • get your child’s attention before you talk to them
  • speak to your child clearly and slowly face-to-face
  • cut down background noise
  • 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

Non-surgical treatments 

Your child may need to wear hearing aids if they have hearing loss in both ears and surgery isn’t an option. Wearing a hearing aid can make some children anxious, so your doctor will talk to you about your choices.

Your doctor may suggest a technique called autoinflation. This helps to open the Eustachian tube to let air into the middle ear so fluid can drain out. Your child closes their mouth and one nostril and then blows up a balloon using the other nostril.

Antibiotics, antihistamines, steroids and decongestants don’t work as treatments for glue ear. There is also no evidence that complementary therapies such as homeopathy or special diets will help.

Surgery

Your doctor may suggest surgery if the glue ear is no better after three months and your child has severe hearing loss. Surgery is also an option if your child’s learning or development is affected.

The main surgery for glue ear is to make a tiny cut in the ear drum and put in a plastic tube called a grommet. These work by allowing air to get in and out of the middle ear, which helps to drain the fluid. Grommets are usually put in with a general anaesthetic, which means your child will be asleep during the procedure.

Grommets can improve hearing for up to nine months, but they have little effect on speech or language development in the long term. Different grommets stay in for different lengths of time, but eventually they fall out and the eardrum closes.

Your child may have surgery if they have recurrent middle ear infections, which can often occur together with glue ear. In this case, grommets can be put in at the same time as an adenoidectomy. This means having the adenoids taken out – these are lumps of soft tissue at the back of your child’s nose. This is usually only done if your child also has lots of coughs, colds and sore throats.

Causes of glue ear

Doctors aren’t completely sure why glue ear happens. Different factors are involved, but in more than a half of children glue ear follows an infection of the middle ear.

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 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 fed from a bottle when lying down
  • have contact with lots of children, such as at a nursery, or have older siblings
  • have a cleft palate or Down’s syndrome

Frequently asked questions

  • Your surgeon is likely to ask you to keep 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.

    You’ll be asked to take care when bathing, showering or washing your child’s hair. You’ll also be asked not to take your child swimming.

    Surgeons give different advice about how long you’ll need to do this, so ask for information. After the first few weeks, there’s no evidence that wearing earplugs or not swimming or bathing will make any difference to the likelihood of getting an infection.

  • It’s usually OK to fly if your child has glue ear. However, if your child has an ear infection it can sometimes cause problems.

    As an aeroplane takes off, the air pressure in the cabin drops and that causes gases to expand. As the aeroplane comes down to land, the air pressure increases and gases contract. These changes affect the air in your middle ear and if your child has a middle ear infection, it can be painful and can cause injury. It’s a good idea to check with your GP before your child travels. They may prescribe decongestant nose drops to use before take-off and landing.


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Related information

    • Otitis media with effusion. PatientPlus. www.patient.info, last edited February 2016
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    • Otitis media with effusion. NICE Clinical Knowledge Summaries. cks.nice.org.uk revised October 2016
    • Otitis media (secretory). The MSD Manuals. www.msdmanuals.com, last reviewed September 2017
    • Otitis media with effusion in under 12s: surgery. National Institute for Health and Care Excellence (NICE), 2008. www.nice.org.uk
    • Glue ear. National Deaf Children’s Society. www.ndcs.org.uk, accessed February 2019
    • Assessing and treating children with suspected otitis media with effusion (without Down’s syndrome or cleft palate). National Institute for Health and Care Excellence (NICE). pathways.nice.org.uk, last updated May 2017
    • Middle ear. Oxford handbook of ENT and Head and Neck Surgery (online). Oxford Medicine Online. oxfordmedicine.com, published August 2010
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    • Venekamp RP, Mick P, Schilder AGM, Nunez DA. Grommets (ventilation tubes) for recurrent acute otitis media in children. Cochrane Database of Systematic Reviews 2018, Issue 5. Art. No.: CD012017. DOI: 10.1002/14651858.CD012017.pub2. www.cochranelibrary.com
    • Adenoidectomy. Medscape. emedicine.medscape.com, updated July 2015
    • Medical Research Council Multicentre Otitis Media Study Group. Surgery for persistent otitis media with effusion: generalizability of results from the UK trial (TARGET). Trial of Alternative Regimens in Glue Ear Treatment. Clin Otolaryngol Allied Sci 2001; 26(5):417–24
    • Moualed D, Masterson L, Kumar S, et al. Water precautions for prevention of infection in children with ventilation tubes (grommets). Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No.: CD010375. DOI: 10.1002/14651858.CD010375.pub2. www.cochranelibrary.com
    • Cabin air pressure. World Health Organisation. www.who.int, accessed February 2019
    • Flying with medical conditions. PatientPlus. www.patient.info, last edited November 2015
  • Reviewed by Alice Windsor, Specialist Health Editor, Bupa Health Content Team, May 2019
    Expert reviewer, Mr Anil Banerjee, Ear, Nose and Throat Consultant
    Next review due May 2022



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