What is Glue Ear?
Glue ear is a condition where sticky fluid builds up in the middle ear, just behind the eardrum. This can make it harder for soundwaves to pass from the ear drum to the hearing bones (ossicles). This often leads to mild-moderate temporary hearing loss.
This is believed to happen because the eustachian tube, which connects the middle ear to the back of the throat and normally helps drain fluid and equalise air pressure in the middle ear, becomes blocked or doesn’t function properly.
As a result, fluid collects behind the ear drum instead of draining away. Glue ear is especially common in children, with up to 80% estimated to experience it before the age of 10, but can affect people of all ages. It often develops after a cold or ear infection and may come and go over time.
Symptoms in children
Glue Ear is a painless condition which can cause mild/moderate temporary hearing loss. If you have noticed any of the following symptoms in your child, they could be suffering with glue ear:
Dulled Hearing
The sticky glue-like fluid associated with the condition dampens the vibrations made by soundwaves causing a reduction in hearing ability
Social Isolation
Hearing loss reduces a child’s awareness of their environment and can leave them feeling left out
Speech & Language Problems
In some cases, it can cause stunted speech and language development
Selective Hearing
Children can appear to have selective hearing, for example not responding when their name is called
Learning Challenges
Difficulty hearing the teacher can lead to a child’s school work deteriorating
Clumsiness or Balance Problems
Ear conditions can cause balance problems
Using a Louder Volume
If your child is turning the volume up louder than usual on household devices
Babies less responsive to sound
Children yet to develop speech who suffer from glue ear are less responsive to sound
Treatment
GP
You should consult your GP if you notice your child’s behaviour matching the symptoms. If your GP suspects glue ear as the cause they will likely ask you to observe a “watch and wait” or “monitoring and support” period. This happens because up to 50% of glue ear cases will spontaneously resolve without treatment.
%
50% of glue ear cases will spontaneously resolve without treatment
Audiologist
If your child’s symptoms persist your GP will refer you to an Audiologist. Using a tympanometry test the Audiologist will diagnose glue ear. At the point of diagnosis, you will likely be asked to continue the active observation period. If the condition persists after this, they will either recommend you use Otovent or refer you to an ENT surgeon for grommet surgery. Otovent is available for your GP or Prescribing Audiologist to prescribe.
What causes glue ear?
While doctors are not completely sure what causes glue ear, they have identified a number of factors which are believed to play a role.
For example, it often develops following a common cold or upper respiratory tract infection. This is due to excess mucus becoming trapped behind the eardrum instead of draining away. This build-up can lead to the development of the condition.
It can also follow an acute middle ear infection (otitis media).
Some also believe that allergies and environmental factors like air quality can play a role.
Children with Down’s Syndrome or cleft palate are also more prone to the condition. This is because their eustachian tubes are typically smaller or may not function as effectively. This makes it harder for fluid to drain properly.
Children in general are more prone to glue ear because their eustachian tubes are smaller and more horizontal than adults’. In turn, it is believed that the eustachian tubes shrink with age, which is why older adults can also experience the condition.
How can I best prevent my child from getting glue ear?
While glue ear is common and not always preventable, there are steps you can take to help reduce the risk. One of the most important things is to avoid exposing your child to cigarette smoke. This is because second-hand smoke can irritate the airways and increase the likelihood of fluid build-up in the middle ear. If you smoke, be sure to do so outside and away from your child.
Managing allergies is also important, as allergic reactions can cause inflammation and swelling of the eustachian tubes. This can make it harder for fluid to drain properly. Keeping your child’s nose clear during colds (blowing not sniffing), encouraging good hand hygiene to prevent infections, and supporting a healthy immune system with a balanced diet and plenty of sleep can also play a role in prevention.
If your child is prone to glue ear, regular check-ups with your GP can help monitor their ear health and catch any issues early.
What are the long-term effects of glue ear?
Although glue ear tends not to cause any pain, an increasing body of scientific literature points to potential long-term effects on children. Some include:
- Speech and language difficulties.
- Poorer auditory processing skills
- Social and behavioural issues.
A short summary of some of this research can be found here.
Can my child fly with glue ear?
Children with glue ear can usually fly, but the change in cabin pressure during take-off and landing may cause some discomfort or a feeling of fullness in the ears.
This is because the rapid altitude changes cause an imbalance in middle ear pressure which exerts itself on the ear drum. This is usually resolved by the opening of the eustachian tubes which connect the middle ear to the back of the throat.
However, blocked eustachian tubes are believed to be behind glue ear, so children with the condition are unlikely to be able to equalise their ear pressure on a plane.
To help reduce discomfort, you can encourage your child to swallow, yawn, or drink during take-off and landing. Otovent is also clinically proven to help relieve barotitis (ear pain when flying), so may be worth considering too.
If you’re unsure, it’s always a good idea to speak to your GP before travelling.