What is glue ear?

Glue ear is when children have sticky fluid in their middle ear behind the eardrum.  It often follows one or more middle ear infections.   The fluid may last for many weeks or months.  Sometimes Glue ear occurs when there does not seem to have been an infection. The fluid in the middle ear makes it harder for your child to hear. As children grow and develop glue ear occurs less often.  Glue ear is most common in toddlers and preschoolers.

 

What are the symptoms?

Many children with glue ear do not have any symptoms.

Some have problems hearing.  Signs of hearing difficulty include loud children.  They may want to have spoken words repeated or shout.  They may like music or television on high volumes.  Parents or teachers may notice this, especially in noisy situations. 

Consider background noise in classrooms, birthday parties or swimming pools.

Your child may have some pressure or pain in the ear from time to time.

In smaller children, hearing difficulties may affect their speech development.

Some children seem to be more irritable and have problems sleeping.

A few children with glue ear have problems with balance.

 

Complications of glue ear

Reduced hearing may cause some speech and language delay in children under 3. In most cases, the delay is only temporary.  The children often catch up once their hearing returns to normal.

An acute middle ear infection is a common complication.  When an infection occurs in the fluid, this can cause ear pain and fevers. Symptoms usually pass in 2-3 days without treatment.  Consult your GP if your child develops these symptoms.  Antibiotics may help. 

A perforated eardrum is often painful and occurs during an infection.  This is not common and often heals by itself without intervention.  Adults may also suffer from a perforated ear drum or fluid in the ears.

 

Treatment

See your GP to diagnose and track glue ear for the first three months.   Your doctor calls this "active observation" or "watchful waiting." Research shows about half of all cases will resolve within the three months. 

Medical advice may include antibiotics for a 2-3 week interval to try to clear the fluid.  Medications such as antihistamines, decongestants and antibiotics are often used for glue ear.  Current evidence shows they have little effect in shortening the duration of symptoms. All medications may have side effects.


If glue ear persists, you will seek a specialist opinion.  An audiologist is a health professional who can test hearing.  Often hearing tests check how much the glue ear affects hearing.  If hearing and speech are affected surgery is often helpful.  An ear, nose, and throat (ENT) specialist will discuss surgical options.  The surgery is brief. Usually, surgery is a day procedure.  The purpose is to allow the fluid in the middle ear to drain.  The surgeon places small ventilation tubes (called "grommets") in your child's ears.  These tubes help fluid drain from the middle ear.

 

Recent research in the UK into a new treatment has been encouraging.  The new technique is auto-inflation. Auto-inflation involves your child blowing up a special balloon using their nose. It helps to open up the Eustachian tube, making it easier for the tube to drain fluid from the middle ear. The research recommends auto-inflation in the active observation period.  The aim is to reduce the duration of glue ear.  Auto-inflation is usually performed daily at home.  You will need to continue auto-inflation until all the fluid has drained away.

Auto-inflation can be difficult for young children to do and isn't always suitable.

If auto-inflation causes your child pain, treatment should stop.

Please be aware auto-inflation is for healthy children and adults.   Don't use this if they have a cold, chest infection, throat infection or flu.

 

 

Here are some helpful links
http://www.racgp.org.au/your-practice/guidelines/handi/interventions/chi...
http://www.nhs.uk/Conditions/Glue-ear/Pages/Treatment.aspx

Dr. Lisa Agnew is a Registered Osteopath, passionate about working with children.  Alliance Health Clinics Mitcham now stocks Otovent auto-inflation devices.  Feel free to contact our clinic if you have questions about how osteopathy may help to treat glue ear.  Lisa has a particular interest in working with toddlers and preschoolers.