23 November 2017
Professor Iain Bruce, Consultant Paediatric Otolaryngologist
What is glue ear?
Glue ear (also known as otitis media with effusion or OME) is a common childhood condition characterised by the build-up of fluid within the middle ear, without signs of acute infection. The middle ear is the air-filled space behind the eardrum, across which the bones of hearing carry the sound signal from the eardrum to the hearing organ (cochlea).
The presence of fluid behind the eardrum negatively affects the efficiency of movement of the three bones of hearing in the middle ear. Ultimately, the fluid dampens down the strength of the vibration signal and as a result the sound is heard as a quieter noise. There are two peaks in the incidence of glue ear, when children are around three and five years of age. Glue ear is very common and 80% of children have been affected by 10 years of age.
What problems can glue ear cause?
Hearing loss is the commonest problem, but sometimes the hearing difficulty can go unnoticed. Less frequently, glue ear may present with earache, poor educational progress, clumsiness, ‘the wobbly child’, abnormal noises in the ears (tinnitus) and intolerance of loud noise (hyperacusis). Hearing loss may be most noticeable in noisy environments.
What are the treatment options for glue ear?
Glue ear may resolve naturally and therefore a period of three months of ‘active monitoring’ following diagnosis is recommended*. If the glue ear persists for over three months with accompanying hearing difficulty then an intervention should be offered. Medicinal treatments have not been shown to be effective in the management of glue ear.
This intervention can take the form of surgically draining the fluid and inserting grommets (ventilation tubes) to aerate the middle ear. Grommets prevent the development of the negative pressure in the middle ear that is thought to be important in the development of glue ear. Alternatively, hearing aids are an option to amplify the sounds sent into the ear, counter-acting the dampening down of the sound signal by the time it reaches the hearing organ. Hearing aids allow the child to hear better, whilst waiting for the natural resolution of the glue ear happening over months to a few years.
It is important to note that neither grommets nor hearing aids are cures for glue ear. Changes in head shape and the immune system are what lead to a decrease in the risk of developing glue ear with increasing age. Grommets and hearing aids are strategies to improve hearing performance whilst waiting for the natural resolution of glue ear with increasing age. The choice of treatment depends on the child and their needs. Some children may do just fine without grommets or hearing aids, developing normally with just increased vigilance at school to support them in the classroom and regular hearing tests.
Professor Bruce is a Consultant Paediatric Otolaryngologist at Spire Manchester Hospital. For more information or to book an appointment please contact 0161 447 6700.
The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.