Glue ear/grommets

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How do we hear?

The ear consists of three parts; the outer ear, the middle ear and the inner ear.

Sound waves enter the ear canal and cause the eardrum to vibrate.  The sound then passes through the middle ear by means of the three small bones of hearing (ossicles), on to the inner ear, which is filled with fluid.  The movement of the fluid in the cochlea stimulates the hair cells inside it to trigger a nerve impulse, which is carried to the brain by the auditory nerve.  The brain then interprets these nerve impulses as sound.

What is glue ear?

Glue ear is a very common condition that affects children. It is also called ‘otitis media with effusion’, which means that the middle ear contains fluids. It occurs when a sticky fluid (glue) builds up inside the ear. This can affect hearing because the parts of the middle ear cannot move freely, although the level of hearing loss is mild to moderate, rather than severe or profound.

What causes glue ear?

It is not exactly known what causes glue ear, but doctors believe it is connected to the Eustachian tube not functioning properly. The Eustachian tube usually keeps the air pressure on both sides of the eardrum equal. If the tube is blocked, this causes the air pressure inside the middle ear to drop. Fluid drains from the surrounding tissue to fill up the middle ear.  With time, this fluid becomes sticky and stops the eardrum and ossicles vibrating properly.

What are the symptoms?

The first symptom parents tend to notice is their child’s speech and language development is behind his/her peers. Any form of hearing loss can cause this but glue ear is the most common form that affects children. Your child might not seem to be listening to you or you may notice that they have the television at a constant high volume.  

Occasionally, children with glue ear have a mild earache, but this is more common with ear infections. Glue ear is not an infection and the fluid building up in the ear rarely contains germs.

How is glue ear diagnosed?

The doctor will start by looking inside your child’s ear to see if there is any visible blockage of the ear canals and to check the appearance of the eardrum. This will be followed by some hearing tests to see whether there is any hearing loss and if so, whether it is caused by glue ear. One of these tests (tympanometry) tests the mobility of the eardrum and can give an indication of whether glue is present.

How common is glue ear?

It is an extremely common condition, which usually tends to affect children under seven years of age, most commonly between the ages of two and five. However, some children have ‘recurrent’ glue ear which means it returns after treatment over a period of some months or years. This can lead to problems in speech and language development, due to hearing problems.

Some children develop glue ear after a cold so it can be more common during the winter months.  

How can it be treated?

The doctor may suggest treatment by using grommets, which are inserted during an operation. Find out more about treatment of glue ear.

What are the benefits?

If a child has an isolated case of glue ear, it may clear up on its own. However, if it persists it may start to affect their speech, language or schooling.

What is the outlook for children with glue ear?

Once glue ear has been diagnosed and treated, the outlook is very good. Most children with speech and language delays catch up and go on to have a normal school life.  A small proportion of children may need extra help from a speech and language therapist.

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