Glue ear is a common condition that causes temporary hearing loss in children. Children are most likely to get glue ear at the age of 2 and around the age of 5, although it is also common at other ages.
For our ears to work, the ear drum needs to be able to vibrate when sound waves hit it. In order for the ear drum to vibrate freely, it needs to have air at the same pressure on either side of the ear drum. See image below:
For our ears to work, the ear drum needs to be able to vibrate when sound waves hit it. In order for the ear drum to vibrate freely, it needs to have air at the same pressure on either side of the ear drum. See image below:
Air can easily get to the outside part of the ear, but the inner part of the ear (called the middle ear) gets air from a tube from the back of the nose. This is called the Eustachian tube. The tube is small, and can easily become blocked.
When the Eustachian tube is blocked, the moist lining of the middle part of the ear absorbs the air in the ear, and the pressure in the middle ear reduces. This can suck the ear drum in (see tympanic membrane retraction), but more commonly it causes the ear to fill up with a sticky fluid we call glue. This fluid makes it difficult for the ear drum to vibrate, and this causes hearing loss:
When the Eustachian tube is blocked, the moist lining of the middle part of the ear absorbs the air in the ear, and the pressure in the middle ear reduces. This can suck the ear drum in (see tympanic membrane retraction), but more commonly it causes the ear to fill up with a sticky fluid we call glue. This fluid makes it difficult for the ear drum to vibrate, and this causes hearing loss:
Most cases of glue ear never need any treatment because they get better on their own quite quickly. Having a short period of time with reduced hearing tends not to be a problem because children can catch up anything they missed quite easily (adults tend to find the hearing loss annoying and have it treated much sooner). However, when the hearing loss goes on for a longer period of time, it becomes much more difficult to catch up what has been missed.
Glue ear is associated with negative effects on auditory processing, language and speech development, school readiness, sociability, wellbeing, and sleep (1).
For that reason, if glue ear persists for some months, we usually recommend a simple procedure to put 'grommets' in the ear (2). This involves making a small hole in the eardrum, sucking the glue out of the ear, and placing a small white plastic tube (called a grommet) to allow air to get into the middle ear via the ear canal. This is very effective at improving the hearing in children with glue ear. The grommets last about 6-12 months, and then fall out by themselves. There is very little risk with the procedure itself, however having a hole in the ear drum for a year or so can cause ear infection in about one in five children who have grommets. If this happens, we treat it with a specific type of antibiotic ear drop. About 2% of children who have grommets have a persistent hole in the ear drum, which can be repaired if necessary. Sometimes, we recommend removing tissue from the back of the nose (called adenoid) because bacteria accumulating on this tissue, which lies next to the Eustachian tube, can make it more likely that glue ear comes back after grommets have fallen out.
References:
1. Panel 5: Impact of otitis media on quality of life and development. Homøe P, Heidemann CH, Damoiseaux RA, Lailach S, Lieu JEC, Phillips JS, Venekamp RP. Int J Pediatr Otorhinolaryngol. 2020 Mar;130 Suppl 1(Suppl 1):109837.
2. Otitis Media with Effusion in under 12s:Surgery. National Incidence of Health and Care Excellence.
Glue ear is associated with negative effects on auditory processing, language and speech development, school readiness, sociability, wellbeing, and sleep (1).
For that reason, if glue ear persists for some months, we usually recommend a simple procedure to put 'grommets' in the ear (2). This involves making a small hole in the eardrum, sucking the glue out of the ear, and placing a small white plastic tube (called a grommet) to allow air to get into the middle ear via the ear canal. This is very effective at improving the hearing in children with glue ear. The grommets last about 6-12 months, and then fall out by themselves. There is very little risk with the procedure itself, however having a hole in the ear drum for a year or so can cause ear infection in about one in five children who have grommets. If this happens, we treat it with a specific type of antibiotic ear drop. About 2% of children who have grommets have a persistent hole in the ear drum, which can be repaired if necessary. Sometimes, we recommend removing tissue from the back of the nose (called adenoid) because bacteria accumulating on this tissue, which lies next to the Eustachian tube, can make it more likely that glue ear comes back after grommets have fallen out.
References:
1. Panel 5: Impact of otitis media on quality of life and development. Homøe P, Heidemann CH, Damoiseaux RA, Lailach S, Lieu JEC, Phillips JS, Venekamp RP. Int J Pediatr Otorhinolaryngol. 2020 Mar;130 Suppl 1(Suppl 1):109837.
2. Otitis Media with Effusion in under 12s:Surgery. National Incidence of Health and Care Excellence.