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Glue ear special

Posted Mar 02 2010 8:29am

glue ear.jpg What is glue ear?
Glue ear is a condition where the middle ear fills with glue-like fluid instead of air.

With fluid blocking the middle ear, it becomes difficult for sound to pass through to the inner ear and can make quieter sounds difficult to hear.

Glue ear is common. More than 7 in 10 children have at least one episode of glue ear before they are four years old. In most cases it only lasts a short while. Boys are more commonly affected than girls.

Glue ear is one of the most common childhood illnesses
Children under the age of five are the largest group affected, although for some it can persist into adolescence. It is widely accepted that glue ear can cause temporary deafness, delayed speech development in young children and affect children’s behaviour and their educational progress.

Glue ear is often, but not always, linked with ear infections. It can sometimes develop unnoticed. Changes in behaviour, becoming tired and frustrated, lack of concentration, preferring to play alone and not responding when called may indicate glue ear. These signs can often be mistaken for stubbornness, rudeness and being naughty. As a result, many children with glue ear are misunderstood or labelled as difficult.

What conditions influence glue ear?
There are many things which can contribute to glue ear. These include colds and flu, allergies and passive smoking. Children with genetic conditions such as Down’s Syndrome may be more likely to get glue ear as they may have smaller Eustachian tubes.

What is the treatment for glue ear?
Watchful waiting
No treatment is usually advised at first as the outlook is good. The length of time advised to 'wait and see' can vary, and depends on certain factors. For example, whether the glue ear is recurrent or new, the severity of the hearing loss, the child's age, etc. For a 'typical' situation, a doctor may advise that you wait several months to see if the glue ear clears.

Balloon treatment
For this treatment a special balloon is blown up by the child using their nose. This is called 'autoinflation'. It puts back-pressure into the nose, and may help to open up the Eustachian tube and allow better drainage of the fluid. The child needs to do this regularly until the fluid clears. The research studies that looked into this treatment found that it seems to help in some cases, but not all. Also, this balloon treatment requires a lot of commitment to do regularly. It is also difficult for young children to do properly. Therefore, with well motivated older children who can use the device, it may be worth a try. It is not thought to cause any side-effects or problems. You can get an autoinflation kit called Otovent on prescription, or you can buy it from pharmacies.

glueear diagram.gif

Surgery
A small operation may be advised by an ear specialist if glue ear persists, or is severe. This involves making a tiny cut (about 2-3mm) in the eardrum under anaesthetic. The fluid is drained and a grommet (ventilation tube) is then usually inserted. A grommet is like a tiny pipe that is put across the eardrum. The grommet lets air to get into the middle ear. Hearing improves immediately.

Grommets normally fall out of the ear as the eardrum grows, usually after 6-12 months. By this time the glue ear has often gone away. The hole in the eardrum made for the grommet normally heals quickly when the grommet falls out. Sometimes grommets need to be put in on more than one occasion if glue ear recurs. (See a separate leaflet called 'Operations for Glue Ear'.)

In some cases, the adenoids are also taken out to improve the drainage of the Eustachian tube. Adenoids are small clumps of glandular tissue (similar to tonsils). They are attached at the back of the nose cavity near to the opening of the Eustachian tube.

Hearing aids
Hearing aids are an option, although these would usually only be used for the time until the glue ear clears away.

Download the glue ear publications from the NDCS, here.

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