Glue ear in children: how to treat it and prevent it

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Glue ear, medically known as otitis media with effusion (OME), is a condition where the middle ear fills with a sticky, glue-like fluid, rather than air. This fluid build-up can cause hearing difficulties because it prevents the eardrum and small bones in the ear from vibrating effectively. Glue ear in childhood is particularly common, especially in children under the age of 8 and can occur in one or both ears. While it often resolves on its own, but persistent cases of glue ears in kids may require medical intervention. Learn everything you need to know about glue ear in children in our article.

What's glue ear? Definition

Glue ear, also known as otitis media with effusion (OME), occurs when the middle ear (located behind the eardrum) fills with sticky fluid. Often referred to as sticky ear, this condition is quite common, particularly in young children. In fact, 1 in 5 pre-schoolers has glue ear at any given time, and 8 out of 10 children will experience it at least once before they turn 10. For ears to function properly, the middle ear needs to remain filled with air, which is supplied through the eustachian tube. This tube connects the middle ear to the back of the throat. However, in children, the eustachian tube is narrower and less vertical than in adults, which makes it more prone to blockage. When the tube becomes blocked, air cannot enter the middle ear. As a result, the cells lining the middle ear produce fluid that starts as a thin liquid but can thicken over time, leading to the characteristic sticky fluid of glue ear. If your child has glue ear, their doctor might describe their ear or ears as ‘congested.’ This congestion blocks sound transmission to the inner ear, making quieter sounds harder to hear. Glue ear can affect one or both ears and is a common cause of temporary hearing issues in children.

Glue ear and toddler behaviour

Glue ear is a common condition in infants where fluid accumulates behind the eardrum without signs of acute infection. This eardrum effusion can significantly impact a child's behaviour and development. What is the behaviour of a child with glue ears? Infants with glue ears may exhibit signs of hearing difficulties, as the fluid dampens sound transmission. Parents might notice that their child is less responsive to sounds or requires louder volumes to react. This hearing impairment can lead to speech and language delays, as the child may struggle to hear and mimic sounds essential for language acquisition. Behaviorally, a child with glue ear might display increased irritability or frustration, stemming from the challenges in communication and understanding their environment. They may also become more withdrawn or exhibit attention difficulties, as the muffled hearing can make it hard to engage fully in activities or follow instructions. Additionally, balance issues can arise because the middle ear plays a role in maintaining equilibrium. Infants might appear clumsier or have delayed motor skills compared to their peers. It's important to note that these behaviours can be subtle and may develop gradually. If glue ear is suspected, especially if accompanied by noticeable speech delays or frequent ear infections, consulting a paediatrician or an ear, nose, and throat specialist is crucial. Early detection and management, which may include monitoring, hearing assessments, or interventions like the insertion of grommets to drain the fluid, can help mitigate potential developmental delays and improve the child's quality of life.

Glue ear and toddler's speech delay

Glue ear is a prevalent condition among toddlers, characterized by the accumulation of fluid in the middle ear. This fluid buildup can lead to temporary hearing loss, which may adversely affect a child's speech and language development. During the critical period of language acquisition, clear auditory input is essential for toddlers to learn and replicate sounds. When hearing is compromised due to glue ear, speech may sound muffled and unclear, making it challenging for the child to discern and imitate words accurately. Consequently, this can result in delayed speech milestones, limited vocabulary growth, and difficulties in articulating certain sounds.  Parents might observe that their child is less responsive to verbal cues, frequently asks for repetition, or exhibits frustration during communication attempts. Additionally, toddlers with glue ear may display behavioral changes, such as increased irritability or a tendency to withdraw from social interactions, stemming from the challenges in understanding and being understood. Early detection and intervention are crucial. If glue ear is suspected, consulting a healthcare professional is recommended. Treatment options vary based on the severity and duration of the condition. In many cases, glue ear resolves spontaneously without medical intervention. However, if the condition persists and significantly impacts hearing and speech development, medical treatments such as the insertion of grommets (tiny tubes placed in the eardrum to drain fluid) or hearing aids for children may be considered.

In the interim, parents can support their child's communication development by minimizing background noise, maintaining eye contact during conversations, and speaking clearly and at a moderate pace. Engaging in interactive activities that promote language skills, such as reading together and encouraging pretend play, can also be beneficial. By addressing glue ear promptly and implementing supportive communication strategies, parents can help mitigate potential speech delays and foster their child's language development.

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Is glue ear linked to autism in kids?

Glue ear, or otitis media with effusion, involves fluid accumulation in the middle ear, leading to hearing difficulties. Research indicates a higher prevalence of glue ear among autistic children compared to their neurotypical peers. For instance, the National Deaf Children's Society notes that hearing loss in children with autism is ten times higher than in the general population, with glue ear being a common cause. A study published in BMJ Open found that young children with common ear, nose, and throat (ENT) issues, such as glue ear, may be at an increased risk of autism or exhibit higher levels of autistic traits. The researchers suggest that early identification and treatment of ENT conditions could improve quality of life and potentially shed light on some origins of autism. However, it's essential to understand that while there is an association between glue ear and autism, this does not imply causation. The exact relationship remains complex and not fully understood. Some experts propose that anatomical differences in the ear structure of autistic individuals might increase susceptibility to ENT conditions. 

Can glue ear cause ADHD in children?

While glue ear itself doesn't directly cause Attention Deficit Hyperactivity Disorder (ADHD), research suggests a potential association between recurrent ear infections and the development of ADHD-related behaviors. Studies have indicated that children experiencing frequent otitis media may exhibit increased inattentiveness, hyperactivity, and impulsivity—core symptoms of ADHD. One study found that children with a history of otitis media had a higher prevalence of ADHD compared to those without such a history. The proposed link between glue ear and ADHD may involve several factors:

  • Hearing Impairment: Chronic hearing loss from glue ear can impede language development and auditory processing, potentially leading to attention and behavioral issues.
  • Neurological Impact: Persistent middle ear infections might affect neural pathways related to attention and behavior.
  • Social and Educational Challenges: Hearing difficulties can result in academic struggles and social isolation, which may contribute to behaviors associated with ADHD.

It's important to note that while there's an observed correlation, causation hasn't been established. Not all children with glue ear develop ADHD, and not all individuals with ADHD have a history of ear infections. Early detection and treatment of glue ear are crucial to mitigate potential hearing loss and its associated developmental challenges. If a child exhibits persistent attention or behavioral concerns alongside a history of ear infections, consulting healthcare professionals for comprehensive evaluation and intervention is recommended.

Glue ear symptoms in children

Glue ear, medically known as otitis media with effusion, is a prevalent condition in children where sticky fluid accumulates in the middle ear, leading to various symptoms. The primary sign of glue ear is temporary hearing loss, which can affect one or both ears simultaneously. Children may seem inattentive, frequently ask for repetition, or turn up the volume on electronic devices. While ear pain is less common, some children might experience discomfort or a sensation of fullness in the ear. Occasionally, tinnitus—perceiving sounds like ringing or buzzing—can occur. Balance issues may also arise, as the middle ear plays a role in maintaining equilibrium. This can result in clumsiness or unsteady walking. It's important to note that glue ear discharge is not typically associated with this condition. However, if a child has undergone surgical intervention, such as the insertion of grommets (tiny tubes placed in the eardrum to drain fluid), a discharge may be observed for a couple of days post-surgery. If the discharge persists beyond this period, it's advisable to consult a healthcare provider. In many cases, glue ear resolves on its own without treatment. However, if symptoms persist beyond three months or significantly impact the child's hearing and quality of life, medical evaluation is recommended. Treatment options may include watchful waiting, autoinflation techniques, or surgical interventions like the insertion of grommets to ventilate the middle ear and prevent fluid accumulation. Early detection and appropriate management of glue ear are crucial to prevent potential delays in speech and language development, ensuring the child's overall well-being. 

Glue ear symptoms in 2 year olds and infants

Glue ear, or otitis media with effusion, is common in infants and toddlers, including 2-year-olds. It involves fluid accumulation in the middle ear, leading to hearing difficulties. Recognizing symptoms of glue ear in this age group is crucial for timely intervention.

In 2-year-olds, glue ear symptoms may include:

  • Hearing difficulties: Children might not respond when called, frequently ask for repetition, or increase the volume on electronic devices.
  • Speech and language delays: Hearing loss can impede language development, leading to unclear speech or limited vocabulary. 
  • Behavioral changes: Frustration, irritability, or withdrawal from social interactions may occur due to communication challenges. 
  • Balance issues: The middle ear's role in balance means fluid buildup can cause clumsiness or unsteady walking. 

In infants, glue ear symptoms can be subtler:

  • Lack of response to sounds: Infants may not react to familiar voices or noises. 
  • Feeding difficulties: Discomfort during feeding, especially when lying down, might be evident. 
  • Sleep disturbances: Increased restlessness or frequent awakenings can occur. 
  • Ear tugging: Infants might pull at their ears, indicating discomfort. 

If glue ear is suspected, consult a healthcare professional for evaluation and potential treatment to support your child's hearing and development.

What signs should I look out for?

Glue ear may impact your child’s hearing, so it’s important to watch for key signs. These include:

  • You need to raise your voice for your child to hear you.
  • Your child’s speech development is delayed or not progressing as expected.
  • Your child seems frustrated, possibly throwing temper tantrums, or becomes withdrawn.

Symptoms of glue ear in adults

Glue ear, medically known as otitis media with effusion, occurs when fluid accumulates in the middle ear without signs of infection. While more common in children, adults can also experience this condition. Recognizing glue ear symptoms in adults is crucial for timely intervention. The most prevalent symptom is hearing loss, often described as sounds being muffled or as if one's ears are plugged. This hearing impairment can affect one or both ears and may fluctuate over time. Adults may also experience a sensation of fullness or pressure in the affected ear(s), akin to the feeling during altitude changes. This discomfort can be persistent and may lead to earaches. Tinnitus, characterized by ringing or buzzing noises in the ear, is another symptom associated with glue ear in adults. This internal noise can vary in intensity and may disrupt concentration and sleep. In some cases, balance issues or dizziness may occur due to the middle ear's role in maintaining equilibrium. These symptoms can increase the risk of falls or accidents. Chronic glue ear in adults, where symptoms persist for three months or more, can lead to prolonged hearing difficulties and may require medical intervention. If you experience these symptoms, it's advisable to consult a healthcare professional for proper diagnosis and treatment. Early detection and management are essential to prevent potential complications and improve quality of life.
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What causes glue ear in adults and kids?

Glue ear involves the accumulation of fluid in the middle ear, leading to hearing difficulties. While it predominantly affects children, adults can also experience this condition.

Causes in Children

In children, glue ear often results from Eustachian tube dysfunction. The Eustachian tube, which connects the middle ear to the back of the throat, helps equalize ear pressure and drain fluids. In young children, this tube is narrower and more horizontal, making it prone to blockages. Factors contributing to glue ear in children include:

  • Upper Respiratory Infections: Colds and infections can cause inflammation, leading to fluid buildup in the middle ear.
  • Allergies: Allergic reactions can inflame the nasal passages and Eustachian tube, hindering fluid drainage.
  • Exposure to Tobacco Smoke: Passive smoking increases the risk of developing glue ear.
  • Attendance in Group Childcare: Increased exposure to infections in group settings can lead to higher incidences of glue ear.

Causes in Adults

Although less common, glue ear in adults can arise due to:

  • Eustachian Tube Dysfunction: Similar to children, blockages or malfunctions in the Eustachian tube can lead to fluid accumulation.
  • Upper Respiratory Infections: Colds, sinus infections, or other respiratory issues can cause inflammation and fluid buildup.
  • Allergies: Seasonal or environmental allergies may contribute to Eustachian tube blockage.
  • Anatomical Abnormalities: Structural issues, such as nasal polyps or tumors, can obstruct the Eustachian tube.
  • Sudden Air Pressure Changes: Rapid changes in altitude or air pressure, as experienced during air travel or scuba diving, can affect Eustachian tube function.

Understanding the underlying causes of glue ear is essential for effective prevention and treatment. If symptoms persist, consulting a healthcare professional is recommended for appropriate management.

Factors that may influence glue ear in kids

  • Colds, Flu, and Ear Infections: Glue ear can often be associated with common illnesses such as colds, flu, and ear infections, although it is not always directly linked.
  • Genetic Conditions and Anatomical Differences: Children with conditions such as cleft palate or Down’s syndrome are more prone to glue ear due to narrower or less effective eustachian tubes, which can hinder proper drainage and function.

Preventive and Contributory Factors

  • Breastfeeding: Breast milk provides essential nutrients and immune protection that can help infants combat infections during their early months. Research indicates that children breastfed from birth have a lower risk of developing glue ear.
  • Feeding Position: Feeding babies (whether breastfeeding or bottle-feeding) in a sitting position rather than lying flat can help reduce the chance of fluid entering the eustachian tubes.
  • Smoke-Free Environment: Children exposed to smoke are more susceptible to glue ear and ear infections.
  • Research Findings: Studies by the Department of Health show a direct link between a smoky environment and a higher risk of glue ear.
  • Recommendations: Parents should ensure a smoke-free environment at home and in the car. If a completely smoke-free environment isn’t feasible, smoking should be limited to areas children rarely access, as even opening windows won’t remove harmful particles lingering in the air.

Allergies

  • Persistent glue ear in some children may be linked to allergies. Allergens such as fur, pollen, dust mites, or certain foods can cause swelling in the eustachian tube, obstructing fluid drainage from the middle ear.
  • Testing and Resources: Consult a GP for allergy testing or a referral to an NHS allergy clinic. For additional information, contact Allergy UK.
  • These factors highlight potential contributors and preventive measures for managing glue ear effectively.
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At what age do children grow out of glue ears?

Children typically grow out of glue ear, also known as otitis media with effusion, by the age of 7 to 8 years. This condition is most common in children between the ages of 2 and 5 years and tends to resolve as the Eustachian tubes mature and improve in function.

Why Glue Ear Improves with Age

  • Eustachian Tube Development: In younger children, the Eustachian tube is shorter, more horizontal, and less efficient at draining fluid from the middle ear. As children grow, the tube becomes longer and more angled, improving drainage and reducing the likelihood of fluid buildup.
  • Immune System Maturation: A developing immune system becomes better at fighting upper respiratory infections, which are often associated with glue ear.
  • Reduction in Exposure: As children grow, they are less likely to be in environments, such as daycare, where frequent colds and infections occur, further reducing the risk of glue ear.

When to Seek Medical Advice

  • Although glue ear often resolves naturally, if the condition persists for more than three months, significantly impacts hearing, or affects speech and language development, a healthcare provider should evaluate the child. In some cases, treatments such as hearing aids, autoinflation, or grommets (ventilation tubes) may be recommended to alleviate symptoms and prevent complications. Early intervention is key to ensuring glue ear doesn't affect a child's long-term development.

What does glue ear look like?

Young girl covering her ear with her hand because of the pain

Glue ear, or otitis media with effusion, involves fluid accumulation in the middle ear, leading to hearing difficulties. While the condition itself isn't visible externally, medical examination reveals specific characteristics. During an otoscopic examination, a healthcare professional may observe a retracted eardrum, appearing pulled inward due to negative pressure in the middle ear. The eardrum might also look cloudy or dull, differing from its typical translucent appearance. In some cases, bubbles or a fluid line are visible behind the eardrum, indicating the presence of fluid. It's important to note that glue ear is distinct from earwax buildup. While earwax (cerumen) accumulates in the external ear canal and can cause hearing issues if impacted, glue ear involves fluid behind the eardrum in the middle ear. Therefore, glue ear wax isn't a medically recognized term, as the two conditions affect different parts of the ear and have separate causes and treatments. If you suspect glue ear, especially if experiencing hearing loss or a sensation of fullness in the ear, consult a healthcare professional for an accurate diagnosis and appropriate management.

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Otitis and glue ear treatment in childhood

Otitis media with effusion, commonly known as glue ear, is a prevalent condition in children characterized by the accumulation of fluid in the middle ear without signs of acute infection. This fluid buildup can lead to hearing difficulties and, if persistent, may affect speech and language development.

Treatment Approaches:

Watchful Waiting

In many cases, glue ear resolves spontaneously within three months. During this period, regular monitoring is essential to assess hearing and ensure the condition doesn't adversely impact the child's development. 

Autoinflation

This non-invasive technique involves the child inflating a balloon through each nostril, which can help open the Eustachian tube and promote fluid drainage from the middle ear. It's a simple and cost-effective remedy for glue ear, though its suitability depends on the child's age and ability to perform the procedure correctly. 

Surgical Intervention

If glue ear persists beyond three months and significantly impairs hearing, surgical options may be considered:

Grommet Insertion

A minor procedure where tiny tubes (grommets) are placed in the eardrum to ventilate the middle ear and facilitate fluid drainage. This treatment for fluid in the ear can provide immediate hearing improvement. 

Adenoidectomy

In some cases, removing the adenoids can prevent the recurrence of glue ear, especially if enlarged adenoids contribute to Eustachian tube blockage. 

Hearing Aids

For children with persistent glue ear who are not suitable candidates for surgery, hearing aids can be an effective solution to manage hearing loss until the condition resolves.

Preventive Measures

While it's challenging to prevent glue ear entirely, reducing exposure to tobacco smoke, ensuring up-to-date vaccinations, and promoting good hygiene can lower the risk of upper respiratory infections that may lead to glue ear.

Early detection and appropriate management are crucial to minimize the impact of glue ear on a child's hearing and overall development. Regular check-ups with a healthcare professional are recommended to determine the most suitable course of action based on the child's specific circumstances.

How to get rid of glue ear quickly

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What is the fastest way to heal a glue ear? The fastest way to manage glue ear, or otitis media with effusion, depends on its severity and duration. While glue ear often resolves naturally within a few weeks to months, certain methods can expedite recovery. Autoinflation is a non-invasive technique that can aid in clearing the fluid. This method involves using a device like the Otovent nasal balloon, which the patient inflates through the nostril while keeping the other nostril and mouth closed. The process helps open the Eustachian tube, facilitating fluid drainage from the middle ear. It's typically recommended for children over three years old and should be performed several times daily for optimal results. In cases where glue ear persists beyond three months or causes significant hearing impairment, surgical intervention may be considered. The most common procedure is the insertion of tympanostomy tubes, or grommets, into the eardrum. These small tubes ventilate the middle ear and prevent fluid accumulation, thereby improving hearing. Grommets usually remain in place for six to twelve months and fall out naturally as the eardrum heals. It's important to note that certain medications, such as antibiotics, antihistamines, and decongestants, have not proven effective in treating glue ear. Therefore, they are generally not recommended for this condition. Consulting with a healthcare professional is crucial to determine the most appropriate course of action based on the severity and duration of symptoms. They can provide personalized advice and monitor progress to ensure effective management of glue ear.

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Discharge and glue ear exercises

Glue ear, or otitis media with effusion, involves fluid accumulation in the middle ear, leading to hearing difficulties. While ear discharge isn't typical in glue ear, it can occur, especially following surgical interventions like grommet insertion. If discharge persists beyond a few days post-surgery, it's essential to consult a healthcare provider. To alleviate glue ear symptoms, certain exercises may promote middle ear aeration and facilitate fluid drainage:

  • Autoinflation with Nasal Balloons: This technique involves inflating a specialized balloon through the nostril, which opens the Eustachian tube and helps equalize pressure in the middle ear. Regular practice can improve hearing and potentially reduce the need for surgical interventions. 
  • Swallowing and Yawning Techniques: Frequent swallowing or yawning can activate the muscles that open the Eustachian tube, promoting ventilation of the middle ear. Encouraging activities like chewing gum or sipping water may naturally induce swallowing.

It's important to note that while these exercises can be beneficial, they may not be suitable for everyone. Consulting with a healthcare professional before starting any exercise regimen is recommended to ensure it's appropriate for your specific condition.

Glue ear treatments in adults

Treatment for glue ear in adults varies based on the severity and duration of symptoms. Initially, a watchful waiting approach is often adopted, as OME can resolve spontaneously within a few months. During this period, regular monitoring by a healthcare professional is essential to assess any changes in hearing or ear health.

If the condition persists or significantly impacts quality of life, medical interventions may be considered. Autoinflation, a technique where the patient inflates a balloon using their nose, can help open the eustachian tube and facilitate fluid drainage. In cases where conservative measures are ineffective, surgical options like the insertion of tympanostomy tubes (grommets) into the eardrum may be recommended. These tubes allow for continuous ventilation of the middle ear and prevent fluid accumulation.

It's important to note that the use of antibiotics or antihistamines is generally not effective for treating glue ear, as the condition is typically non-infectious. Adults experiencing symptoms suggestive of glue ear should consult an otolaryngologist (ENT specialist) for a comprehensive evaluation and personalized treatment plan.

Home remedies for glue ear in adults and kids

How do you get rid of fluid build up in your ear? While glue ear often resolves naturally, certain home remedies may aid in alleviating symptoms for both adults and children.

  • Autoinflation: This technique aims to open the Eustachian tube to facilitate fluid drainage. One common method involves using a device like the Otovent® nasal balloon. The individual inserts the balloon's nozzle into one nostril, blocks the other nostril, and inflates the balloon by blowing through the nose. This process can help equalize pressure and promote fluid clearance. It's important to note that autoinflation is generally not recommended for children under three years old. 
  • Warm Compress: Applying a warm cloth to the affected ear may provide relief from discomfort associated with glue ear. The warmth can help reduce pain and may encourage fluid drainage. Ensure the compress is warm, not hot, to prevent burns, and apply it for short periods.
  • Steam Inhalation: Inhaling steam may help open the Eustachian tubes, facilitating fluid drainage. This can be achieved by sitting in a bathroom with a hot shower running or using a bowl of hot water, inhaling the steam gently. Caution is advised to avoid burns, especially with children.
  • Hydration and Positioning: Maintaining adequate hydration can thin mucus, potentially aiding in fluid drainage. Additionally, keeping the head elevated, especially during sleep, may reduce Eustachian tube blockage and promote drainage.

It's crucial to consult a healthcare professional before attempting these remedies, especially for children, to ensure they're appropriate and safe. Persistent or severe cases of glue ear should be evaluated by a medical professional to determine if further treatment is necessary.

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New treatments for glue ear in kids

Glue ear, or otitis media with effusion, is a prevalent condition in children characterized by fluid accumulation in the middle ear, leading to hearing difficulties. Traditional treatments include watchful waiting, autoinflation, and surgical interventions like grommet insertion. Recent advancements have introduced alternative approaches to manage this condition.

  • Autoinflation Devices: Building upon traditional autoinflation methods, new-generation devices have been developed to enhance efficacy and usability, especially for young children. These devices often feature a face mask covering the nose and mouth, connected to a tube with a balloon. As the child breathes out, the balloon inflates, increasing pressure to help open the Eustachian tube and promote fluid drainage. Studies suggest that such devices can provide significant relief, with up to 80% of patients experiencing improvement.
  • Pharmacological Research: Investigations into pharmacological treatments for glue ear are ongoing. A systematic review has examined the efficacy of various medications, including antihistamines, leukotriene receptor antagonists, carbocysteine, and steroid nasal sprays. However, current evidence does not support the widespread use of these medications for glue ear in children, and further research is needed to establish their effectiveness.
  • Immunoglobulin A (IgA) Enhancement: Recent studies have identified lower levels of Immunoglobulin A (IgA) in the adenoid tissues of children with glue ear. IgA plays a crucial role in immune defense against infections. Research is underway to explore treatments that could boost IgA levels in the adenoids, potentially reducing the incidence or severity of glue ear.

While these emerging treatments show promise, it's essential for caregivers to consult with healthcare professionals to determine the most appropriate management plan for their child's specific condition.

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Glue ear and grommets: what to know

Glue ear, medically termed otitis media with effusion, is a condition characterized by the accumulation of fluid in the middle ear without signs of acute infection. This fluid buildup can lead to hearing difficulties and, if persistent, may require medical intervention.

One common treatment involves the insertion of grommets, also known as tympanostomy tubes or eardrum grommets. These small tubes are surgically placed into the eardrum to ventilate the middle ear and facilitate fluid drainage. The procedure, typically performed under general anesthesia in children and local anesthesia in adults, involves creating a tiny incision in the eardrum to insert the grommet. This allows air to enter the middle ear, preventing fluid accumulation and improving hearing.

Grommets usually remain in place for six months to a year and often fall out naturally as the eardrum heals. In some cases, especially with long-term tubes, they may stay in place for up to 18 months. While the tubes are in place, it's generally recommended to keep the ears dry to prevent infection, although recent studies suggest that strict water precautions may not be necessary.

Potential complications of grommet insertion include ear discharge, blockage of the tube, or, rarely, persistent perforation of the eardrum after the grommet falls out. However, for many patients, especially children experiencing recurrent glue ear, the benefits of improved hearing and reduced ear infections outweigh these risks.

It's essential to consult with an otolaryngologist (ENT specialist) to determine if grommet insertion is appropriate for managing glue ear, as individual cases may vary.

I can see the grommet in my child's ear: is it OK?

Observing a grommet in your child's ear is typically normal, as these small tubes are inserted into the eardrum to treat conditions like glue ear by allowing air to enter the middle ear and facilitating fluid drainage.

Grommets are designed to remain in place for about 6 to 12 months and usually fall out naturally as the eardrum heals. However, if you notice any of the following symptoms, it may indicate that the grommet is blocked or there is an associated issue:

  • Persistent Ear Discharge: Ongoing fluid discharge from the ear can suggest a blockage or infection.
  • Hearing Difficulties: If your child experiences muffled hearing or a return of hearing loss, it could be due to a blocked grommet. 
  • Ear Discomfort or Pain: Discomfort may arise if the grommet becomes obstructed.

If any of these symptoms occur, it's important to consult your child's healthcare provider. They may recommend treatments such as antibiotic ear drops to address infections or unblock the grommet. In some cases, the grommet may need to be removed or replaced if it becomes dysfunctional. Regular follow-up appointments are essential to monitor the condition of the grommets and ensure they are functioning properly. Maintaining ear hygiene and following medical advice can help manage your child's ear health effectively.

Are ear grommets falling out naturally?

Grommets, also known as tympanostomy tubes, are small devices inserted into the eardrum to treat conditions like glue ear, facilitating fluid drainage and ventilation of the middle ear. Typically, these tubes remain in place for about 6 to 12 months and naturally fall out as the eardrum heals. Observing a grommet in your child's ear canal or noticing its absence can indicate that it has fallen out, which is a normal part of the healing process. After extrusion, the eardrum usually heals without intervention. However, in some cases, the fluid may build up again, causing glue ear to recur, and re-insertion of grommets might be needed. It's important to monitor your child for any signs of recurring ear problems after the grommet has fallen out. If you notice symptoms such as hearing difficulties, ear discomfort, or recurrent ear infections, consult your healthcare provider. They may recommend a follow-up examination to assess whether further treatment is necessary. In some instances, grommets may fall out earlier than expected or remain in place longer than anticipated. If a grommet falls out sooner than six months or stays in for longer than 18 months, it's advisable to visit your doctor for evaluation.

Regular follow-up appointments with your child's healthcare provider are essential to monitor ear health and ensure proper healing after grommet extrusion. Maintaining ear hygiene and adhering to medical advice can help manage your child's ear health effectively.

Blocked grommets symptoms in kids

Grommets, also known as tympanostomy tubes, are small devices inserted into the eardrum to treat conditions like glue ear by facilitating fluid drainage and improving ventilation in the middle ear. While they are effective in reducing the frequency and severity of ear infections, complications can arise if the grommets become blocked. A blocked grommet can impede its function, leading to symptoms such as:

  • Hearing Difficulties: Similar to the original condition, a blocked grommet may cause muffled hearing or a sensation of fullness in the ear.
  • Ear Discomfort or Pain: Discomfort may arise due to pressure changes or fluid buildup behind the blocked grommet.
  • Recurrent Ear Infections: Blockage can prevent proper drainage, increasing the risk of infections.

Common causes of blockage include dried secretions, blood, or debris obstructing the grommet's lumen. Treatment typically involves the use of prescribed ear drops to dissolve the blockage. In some cases, if the blockage persists, the grommet may need to be replaced.

Grommets and ear infections

Grommets, also known as tympanostomy tubes, are small devices inserted into the eardrum to treat persistent ear infections and middle ear fluid accumulation. This procedure, called myringotomy, involves creating a tiny incision in the eardrum to place the tube, allowing air to enter the middle ear and preventing fluid buildup. Children experiencing recurrent acute otitis media (three infections in six months or four within a year) or chronic otitis media with effusion (fluid in the middle ear lasting over three months) are typical candidates for grommet insertion. The tubes help reduce the frequency of ear infections and improve hearing by facilitating proper middle ear ventilation. While grommets effectively manage ear infections, they are not without potential complications. The most common issue is otorrhea, or ear discharge, occurring in 25–75% of cases. Other risks include persistent eardrum perforation, tube blockage, and, rarely, the tube moving into the middle ear. Despite these risks, the benefits of grommet insertion often outweigh the potential drawbacks, especially in children with frequent ear infections or significant hearing loss due to middle ear fluid. In summary, grommets play a crucial role in managing ear infections and related complications. By promoting proper ventilation of the middle ear, they help reduce infection frequency and improve hearing in affected individuals. However, it's essential to consider the potential risks and consult with a healthcare professional to determine if grommet insertion is the appropriate treatment for persistent ear infections.

Ear grommets: side effects in kids

Grommets, or tympanostomy tubes, are commonly used in children to treat persistent middle ear infections and fluid accumulation. While generally safe, the insertion of grommets can lead to certain side effects.

  • One common issue is otorrhea, or ear discharge, which affects approximately 25% of children with grommets. This discharge is often due to water entering the ear or upper respiratory infections. Treatment typically involves antibiotic ear drops and measures to keep the ear dry during activities like bathing or swimming. 
  • Another potential side effect is the blockage of the grommet, which can impede its function. In such cases, ear drops may be prescribed to clear the blockage and restore proper ventilation to the middle ear. 
  • In some instances, a residual perforation, or hole, may remain in the eardrum after the grommet falls out. This occurs in about 1-2% of cases and may require surgical intervention if it does not heal naturally. 
  • Additionally, repeated grommet insertions can lead to tympanosclerosis, a scarring of the eardrum. While this condition is usually harmless, it can sometimes affect eardrum mobility and hearing.
  • It's also important to consider the risks associated with general anesthesia used during the procedure. Although serious complications are rare, some children may experience side effects such as nausea or a sore throat post-operation.

In summary, while grommet insertion is an effective treatment for chronic ear issues in children, it's essential to be aware of potential side effects. Consulting with a healthcare professional can help in making an informed decision and managing any complications that may arise.

Ear grommet surgery in a child: how it works

Ear grommet surgery, or tympanostomy, is a common procedure for children experiencing persistent middle ear infections or fluid buildup, known as otitis media with effusion. The surgery involves inserting small tubes, called grommets, into the eardrum to ventilate the middle ear and prevent fluid accumulation.

  • During the ear grommets procedure, an ENT specialist makes a tiny incision in the child's eardrum to remove any trapped fluid. A grommet is then placed into the incision to allow air to enter the middle ear, facilitating proper ventilation and reducing the risk of future infections. The operation is typically brief, lasting about 20 minutes, and is performed under general anaesthesia.
  • In the UK, private grommet surgery costs for a child can vary depending on the hospital and location. Generally, prices range from £2,000 to £6,500, which may include initial consultations, the procedure itself, and follow-up care. It's advisable to obtain a formal quotation after consultation with an ENT surgeon, as prices can vary based on individual circumstances.
  • Post-surgery, children can usually return home the same day and resume normal activities within a day or two. The grommets typically remain in place for six to twelve months before falling out naturally. While the procedure is generally safe, potential side effects include ear discharge, blockage of the grommet, or, in rare cases, a persistent perforation in the eardrum. It's essential to follow post-operative care instructions and attend follow-up appointments to ensure proper healing and address any concerns promptly.

Is glue ear hereditary?

Sound waves emitted into a man's ear

Glue ear, medically known as otitis media with effusion (OME), involves the accumulation of fluid in the middle ear without signs of acute infection. While it commonly affects children, the exact causes of glue ear are multifactorial, involving both environmental and genetic factors. Recent research has identified specific genetic components that may increase susceptibility to glue ear. Notably, studies involving mouse models have pinpointed the overexpression of the DYRK1A gene as a significant contributor to chronic OME, particularly in individuals with Down syndrome. This gene's overactivity leads to increased inflammation and fluid buildup in the middle ear, suggesting a genetic predisposition in certain populations. Additionally, other genetic studies have indicated that mutations in genes such as Evi1 can predispose individuals to otitis media. Research involving the Junbo mouse model, which carries a mutation in the Evi1 gene, has shown a propensity for developing severe, recurrent glue ear, mirroring the condition in humans. Despite these findings, glue ear is not solely hereditary. Environmental factors play a substantial role in its development. Exposure to second-hand smoke, frequent upper respiratory infections, attendance in group childcare settings, and anatomical variations like cleft palate or Down syndrome can increase the risk of developing glue ear.

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Children with glue ear and swimming: what to know

Glue ear, or otitis media with effusion, is a common condition in children where fluid accumulates in the middle ear, potentially affecting hearing. Parents often wonder if swimming is advisable for children with glue ear, especially if grommets (tiny tubes inserted into the eardrum) have been placed to alleviate the condition. Generally, swimming is permissible for children with glue ear, even those with grommets, but certain precautions are recommended to prevent potential complications. It's advisable to avoid swimming for approximately two weeks following grommet insertion to allow proper healing. After this period, children can resume swimming, but it's important to take measures to keep the ears dry and minimize the risk of infection. Using swimming earplugs or a neoprene headband can help prevent water from entering the ears during swimming. Additionally, it's recommended to avoid swimming in non-chlorinated water, such as lakes, where bacteria levels may be higher, and to refrain from activities like diving or jumping into deep water, as these can increase pressure on the ears. It's important to note that each child may have unique considerations, and not all precautions will be necessary for every individual. Consulting with a healthcare professional or an ENT specialist is essential to receive personalized advice tailored to your child's specific situation. They can provide guidance on appropriate ear protection during swimming and any additional measures to ensure your child's safety and comfort in the water.

Children with glue ear and flying: what to do

Can a child fly with a glue ear? Children with glue ear generally tolerate air travel well, although a doctor’s advice may vary depending on the condition of the ears at the time.

Potential Risks During Flight

  • Changes in cabin pressure during take-off and, more commonly, landing can cause discomfort due to the expansion of fluid in the middle ear. In rare cases, this pressure can lead to a perforated eardrum. If this occurs, a doctor may prescribe antibiotics, but it typically does not result in long-term damage.

Pre-Flight Recommendations

  • It is advisable to consult your GP before flying. They may recommend or prescribe decongestant medication to help manage symptoms and minimize discomfort during the flight.

Tips for a Comfortable Flight

  • Eating and Drinking: Encourage your child to eat or drink during take-off and landing. This helps open the eustachian tubes, reducing pressure and discomfort.
  • Ear Protection: Consider using specialized earplugs such as ‘EarPlanes,’ available at pharmacies, which are designed to alleviate discomfort caused by changes in air pressure.

By taking these precautions, you can help ensure your child’s flight experience is as comfortable as possible.  Read our article about flying with ear infections to learn more.

Is glue ear in children a common condition?

Four out of five children in the UK are likely to experience glue ear before the age of four. However, not all affected children will face hearing difficulties. Approximately half of the cases resolve on their own within three months, without requiring treatment. While glue ear can recur, most children tend to outgrow the condition by around eight years old.

Fluid in middle ear vs. sticky ear

Fluid accumulation in the middle ear, medically termed otitis media with effusion (OME), is commonly known as glue ear when the fluid becomes thick and sticky. Both conditions involve fluid behind the eardrum but differ in viscosity and potential impact on hearing.

  • Fluid in the Middle Ear (OME): OME occurs when non-infected fluid accumulates in the middle ear space. This can result from Eustachian tube dysfunction, allergies, or upper respiratory infections. Symptoms may include a sensation of fullness in the ear, muffled hearing, and occasional discomfort. OME often resolves spontaneously within a few weeks without specific treatment. However, if it persists, interventions may be necessary to prevent complications. 
  • Glue Ear: Glue ear is a more severe form of OME where the fluid becomes particularly thick and adhesive, resembling glue. This increased viscosity can lead to more pronounced hearing loss and may affect balance. Glue ear is more prevalent in children but can also occur in adults. If glue ear persists beyond three months or causes significant hearing impairment, medical evaluation is essential. In many cases, especially with OME, the condition resolves on its own. Regular monitoring ensures it doesn't lead to further issues. It's crucial to consult a healthcare professional for an accurate diagnosis and personalized treatment plan, especially if hearing loss or other symptoms persist.

Cold deafness vs. otitis media

Experiencing hearing loss or tinnitus during a cold, often termed "cold deafness," typically results from mucus accumulation in the middle ear. This buildup occurs when the Eustachian tube, which connects the middle ear to the back of the nose and throat, becomes blocked due to inflammation from a cold or sinus infection. The trapped mucus behind the eardrum can cause a sensation of fullness, discomfort, and temporary hearing impairment.  In contrast, otitis media refers to an infection of the middle ear. This condition often arises when bacteria or viruses infect the accumulated fluid behind the eardrum, leading to symptoms such as ear pain, fever, and hearing difficulties. The presence of mucus in the eardrum area is common in both scenarios; however, otitis media involves active infection, whereas cold-related hearing loss is typically due to non-infected fluid buildup. Treatment approaches differ between the two conditions. For cold-induced hearing loss, alleviating nasal congestion can help restore Eustachian tube function. Methods include steam inhalation, nasal decongestants, and staying hydrated to thin the mucus. In the case of otitis media, medical evaluation is essential. A healthcare provider may recommend watchful waiting, prescribe antibiotics if a bacterial infection is confirmed, or suggest pain management strategies. In some instances, surgical intervention like myringotomy may be necessary to drain the fluid and relieve pressure. It's crucial to consult a healthcare professional for an accurate diagnosis and appropriate treatment, especially if symptoms persist or worsen.

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How to diagnose glue ear: otoscopy and more

Diagnosing glue ear, or otitis media with effusion, involves several key assessments to detect fluid accumulation in the middle ear.

  • Otoscopy: A healthcare professional uses an otoscope—a handheld device with a light and magnifying lens—to examine the eardrum. In cases of glue ear, the eardrum may appear cloudy, retracted, or exhibit visible fluid or air bubbles behind it.
  • Tympanometry: This objective test evaluates the mobility of the eardrum by varying air pressure in the ear canal. A tympanometer measures how the eardrum responds to these pressure changes. In the presence of middle ear fluid, the eardrum's movement is restricted, resulting in a flat tympanogram, indicating reduced compliance. 
  • Audiometry: Hearing tests, such as pure-tone audiometry, assess the degree of hearing loss associated with glue ear. These tests determine the quietest sounds a person can hear at various frequencies, helping to evaluate the impact on hearing function.

A comprehensive diagnosis typically combines these evaluations to confirm glue ear and assess its severity. Early and accurate diagnosis is crucial for effective management and to prevent potential complications, such as speech and language delays in children. If you suspect glue ear, consult a healthcare professional for a thorough examination and appropriate testing.

Hearing aids for glue ear in children

Man walking with a blonde little girl

Hearing aids are a non-invasive treatment option that can effectively manage hearing loss associated with glue ear, especially when surgical interventions like grommet insertion are unsuitable or undesirable. These devices amplify sound, enabling children to hear more clearly despite the fluid buildup. They are typically used temporarily until the condition resolves naturally or through other treatments. The National Health Service (NHS) provides good quality, digital hearing aids free of charge for all children. Learn all about NHS hearing aids in our dedicated article. In some cases, bone conduction hearing devices may be offered as an alternative. The advantages of using hearing aids include avoiding the risks associated with anesthesia and surgery. Children can also participate in their care by selecting the color of the hearing aids and patterns for the ear molds, making the experience more engaging. However, there are considerations to keep in mind. Hearing aids are visible, which may cause self-consciousness in some children. Additionally, parents and caregivers need to manage the maintenance of the devices, such as changing batteries and ensuring they are removed during baths, showers, and swimming. Regular audiology follow-ups are essential due to fluctuations in hearing levels, allowing for adjustments to the hearing aids as needed. It's important to consult with an audiologist or healthcare professional to determine the most appropriate treatment plan for a child with glue ear, considering the severity of hearing loss and the child's individual needs.

Support at school for kids with glue ear

Children’s hearing can be impacted for extended periods while waiting for glue ear to resolve naturally or while on the waiting list for interventions such as grommet surgery or hearing aids. In some cases, glue ear can persist into secondary school, making it crucial to ensure that your child’s speech development and education are not adversely affected.

Impact on development

  • Prolonged glue ear, particularly if it causes mild hearing loss, can significantly affect a child’s learning and development. However, research highlights that schools can implement various strategies to support children with mild hearing loss effectively.

Seeking support

To ensure your child receives appropriate assistance:

  • Communicate with School Staff: Begin by speaking with your child’s teacher or the individual responsible for identifying students with additional educational needs. In England, this is the Special Educational Needs Coordinator (SENCO).
  • Specialist Advice: Reach out to a Teacher of the Deaf (ToD) from your local authority’s specialist education service for deaf children. They can provide guidance and recommend resources tailored to your child’s needs.
With the right support in place, children with glue ear can continue to thrive both academically and socially.

Laws for children with glue ear and hearing loss

England

The Children and Families Act 2014 requires schools to support children with medical conditions, including glue ear. Schools must follow the government guidance, Supporting Pupils with Medical Conditions, which outlines the following responsibilities:

  • Ensure children with medical conditions have full access to education, including physical education and school trips.
  • Provide appropriate training for staff.
  • Assign a person responsible for overseeing support for children with medical conditions.
  • Develop and make available a policy detailing how children with medical conditions are supported.
  • If you feel your child’s needs aren’t being met, ensure the school acknowledges glue ear as a medical condition and ask how they are complying with the guidance.

Wales

  • The Welsh Government provides guidance to schools on supporting children with medical conditions. Contact your child’s school to ensure they are implementing this guidance effectively.

Scotland

  • In Scotland, children with glue ear may be classified as having additional support needs, even if this is only temporary. Schools are required to provide the necessary support under the law. Resources such as the Enquire website offer more details on additional support for learning and parents’ rights.
  • If glue ear significantly impacts education for at least 12 months, it may qualify as a disability under the Equality Act 2010, obligating schools to:
  • Take steps to prevent discrimination.
  • Provide proactive support to mitigate disadvantages.

Northern Ireland

In Northern Ireland, schools must comply with anti-discrimination legislation:

For more details, contact the Equality Commission for Northern Ireland at 028 90 890 890 or visit their website.

Next Steps for Parents

  • Communicate Clearly: Inform the school that glue ear is a medical condition and clarify its impact on your child’s education and well-being.
  • Request a Plan: Ask how the school plans to meet their legal obligations and ensure your child receives adequate support.
  • Seek Specialist Advice: If necessary, consult local educational services, such as a Special Educational Needs Coordinator (SENCO) in England or a Teacher of the Deaf.
  • Advocating for your child’s needs can help ensure they receive the support required to thrive academically and socially.

How to support your child with glue ear at school

If your child has glue ear, it’s important the school understands their needs and provides support. Inform their teacher and/or SENCO that, while glue ear is often temporary, it causes hearing loss that requires extra help. Share your child’s most recent audiogram to clarify what they can and cannot hear.

  • Contact your local authority’s specialist education service for deaf children. Teachers of the Deaf (ToDs) can offer schools guidance, even if direct support isn’t provided for temporary or mild hearing loss. If your child uses a hearing aid, a ToD should be involved.
  • The National Deaf Children’s Society (NDCS) is an excellent resource for schools and families. Share their guidance and deaf awareness tips with your child’s teacher and peers to help them understand how to communicate effectively and include your child in classroom activities.
  • Encourage the school to minimize background noise and ensure communication is clear. Check that an assessment of your child’s needs has been conducted and create a personal profile summarizing their requirements to support staff in tailoring their approach.
  • If needed, discuss Special Educational Needs (SEN) support with the school to ensure your child receives the necessary adjustments. Proactive engagement and shared resources can make a significant difference in your child’s educational experience.

How to support your child with glue ear at home

You can take several steps to help your child cope with glue ear:

  • Ensure you have their attention before speaking.
  • Avoid speaking from behind them.
  • Speak clearly and at a suitable volume (shouting is unnecessary).
  • Encourage them to repeat instructions to confirm they’ve understood.
  • Minimize background noise, like turning off the TV, during conversations.
  • These strategies can make communication easier and support your child’s well-being as they navigate glue ear.
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Hear Glue Ear app for children and families

The Hear Glue Ear app is an innovative tool designed to assist families in managing their child's glue ear at home. Glue ear is a prevalent condition in children aged 2 to 6, and persistent or recurrent cases can potentially impact the development of speech, language, listening, and social communication skills. Developed by Cambridge Digital Health in collaboration with Dr. Tamsin Brown and the Cambridge Hearing Trust Charity, the app aims to support learning and development in children with glue ear, helping to prevent developmental delays. The app offers a range of child-friendly resources, including audiobooks, songs, and listening games, to enhance engagement and auditory skills. For parents, it provides reliable, up-to-date information about glue ear and includes a hearing screen to monitor changes in their child’s hearing over time. Additionally, speech and language therapists can upload therapy sessions directly onto the app, allowing for personalized interventions. A clinician’s portal further enhances its functionality, offering insights into the child’s progress between appointments. By combining educational tools, therapeutic support, and monitoring capabilities, the Hear Glue Ear app empowers families and healthcare professionals to work together in managing glue ear effectively.

FAQs about sticky ears and otitis media

Are there medications for glue ear?

Unfortunately, no medications have been proven effective in treating glue ear. However, healthcare providers can offer guidance on managing the condition and monitoring its progression.

How do you unclog a glued ear?

Glue ear, or otitis media with effusion, often resolves naturally without treatment. If it persists, options include autoinflation techniques, such as the Valsalva maneuver or using a nasal balloon like Otovent, to help open the Eustachian tube and drain fluid. In some cases, surgical intervention with tympanostomy tubes (grommets) may be considered to ventilate the middle ear. 

Will glue ear go away by itself?

Glue ear, or otitis media with effusion, typically resolves on its own within three months without the need for treatment. However, if the condition persists beyond this period, it's important to consult a healthcare professional for further evaluation and potential intervention.

How do you dissolve glue in your ear?

Glue ear, or otitis media with effusion, often resolves naturally without specific treatment. If it persists, autoinflation techniques, such as the Valsalva maneuver or using a nasal balloon like Otovent, can help open the Eustachian tube to facilitate fluid drainage. In some cases, surgical intervention with tympanostomy tubes (grommets) may be considered to ventilate the middle ear.

Should I inform my child’s school?

It’s crucial to inform your child’s school, nursery, or other caregivers about their diagnosis. Educators can make adjustments to support your child, such as seating them at the front of the classroom to help with hearing. Ensuring all teachers and caregivers are aware of the condition is essential for your child’s safety and development.

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