Glue ear

Glue ear is one of the most common childhood conditions. It is often linked with ear infections and is usually temporary, but long-term glue ear can affect children's hearing, speech development, and cause them to fall behind at school. Here we explain what glue ear is and how it can be treated.

A brother and sister play chess together

 

What is glue ear?

A diagram showing the workings of the inner ear

Click image to enlarge.

For ears to work properly the middle ear needs to be kept full of air. The air travels through the eustachian tube which runs from the middle ear to the back of the throat. In children this tube is not as vertical and wide as it will be when they get older and as a result doesn’t work as well. If the eustachian tube becomes blocked, air cannot enter the middle ear. When this happens, the cells lining the middle ear begin to produce fluid. This is a runny liquid which can get thicker as it fills the middle ear.

With fluid blocking the middle ear, it becomes harder for sound to pass through to the inner ear, making quieter sounds difficult to hear. 

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Why does my child have glue ear?

Many things can contribute to glue ear, such as colds and flu, allergies and passive smoking. Children with cleft palate, or with genetic conditions such as Down's syndrome, may be more likely to get glue ear as they often have smaller eustachian tubes that do not function well.

Family by a lake

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How does glue ear affect children?

Changes in behaviour, becoming tired and frustrated, lack of concentration, preferring to play alone and not responding when called may indicate glue ear. These signs can often be mistaken for stubbornness, rudeness and being naughty.

A prolonged period of time with reduced hearing can affect children’s speech development. For example, parts of words may not be pronounced clearly. Children with glue ear may also fall behind at school if they do not have extra support.

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What should I do if I think my child has glue ear?

Arrange an appointment with your family doctor (GP). Often glue ear is associated with a heavy cold and will clear up when the congestion from the cold has gone.

Your GP will examine your child’s ears and should be able to tell if glue ear is present. If there is any pain or sign of infection your GP may prescribe a course of antibiotics. Your GP may want to wait to see if the glue ear clears up by itself before referring your child on to the hospital.

If the symptoms continue ask your GP to refer you to the ear, nose and throat (ENT) department at your local hospital.

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How is glue ear tested?

A specialist doctor will examine your child’s ears and a further assessment will be carried out. This will include a tympanometry test, which measures how well the eardrum can move. If there is fluid in the middle ear the eardrum will not work properly. A graph (called a tympanogram) will show the results straight away. A hearing test should also be done to check if the glue ear is affecting your child’s hearing and by how much.

The specialist doctor should explain the results of all the tests used and discuss the best way to treat your child. It is a good idea to monitor the glue ear with repeated tests at least three months apart. For most children, the glue ear will clear up in this time. If it has not, you may be offered grommets or temporary hearing aids.

See our resource Understanding your Child's Hearing Tests  for further information.

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What treatment is available?

Grommets

Grommets are tiny plastic tubes that are put in the eardrum. They allow air to circulate in the middle ear and stop more fluid from building up. This is done during a short operation in hospital under general anaesthetic. The grommets are inserted after the fluid in the middle ear has been drained away.

A discharge (occasionally blood-stained) may occur for a couple of days immediately after the operation. This is usually because the surgeon has placed antibiotic drops in the ear at the time of the operation. After this time there should not be any discharge. If there is, you should see your GP for advice and antibiotic drops. Any prolonged discharge from the ear should be assessed by your Ear, Nose and Throat (ENT) doctor.

Grommets usually stay in until the eardrum has healed and pushed them out. Sometimes the fluid comes back and another grommet operation may be considered.

Children’s hearing can be affected for long periods of time while waiting to see if the glue ear clears up naturally or while on the waiting list to have the grommet operation. It is important to make sure your child’s speech and education does not suffer during this time. You may want to consider hearing aids or asking for extra support at school.

Our tips about preparing your child for surgery may be helpful if your child is having a grommet operation.

A little boy sitting with his mum plays at being at doctor.

Swimming and bathing with grommets

Some surgeons prefer a child not to swim while they have grommets. This is because the grommets allow direct access of water into the middle ear and a small percentage of children with grommets may develop ear infections. Other surgeons allow swimming with some precautions, such as:

  • Try to avoid your child diving or jumping into the water as this increases the outside pressure and forces water through the grommet into the middle ear.
  • Try to get your child to wear a swimming cap.
  • Don't take your child swimming for at least three weeks after grommet surgery to allow for the operation site to settle down.
  • Avoid your child swimming in lakes or non-chlorinated pools. The water in these places usually has a high bacteria count and infection is more likely to occur.
  • Soapy water allows water to slip through the grommet into the middle ear. If the water is dirty it will infect the middle ear. With your child sitting upright in the bath wash their hair first before body washing. Tilt their head back and rinse the hair off with clean water, then apply a shower cap. This way the child can play in the bath without getting dirty, soapy water in the ear.
Hearing aids

Hearing aids can be useful for children with any level of deafness. There are different types of hearing aid that are suitable for children with glue ear. Most hearing aids work by amplifying (making louder) sounds going into the ear. Good quality, digital hearing aids are available free of charge for all children on the NHS. 

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How can I make hearing easier for my child?

Basic communication tips can help make listening easier for your child – have a look at the deaf awareness section of our website. If your child is getting very tired from the extra effort involved in listening and lipreading, have a look at our concentration fatigue webpage. 

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Can my child fly with glue ear?

Generally children with glue ear don’t experience problems flying, although sometimes doctors don’t recommend it depending on the current condition of the ears.

The build-up of fluid in the middle ear can expand during take-off and, more commonly, landing due to changes in cabin pressure, causing discomfort. The risk is the fluid expands so much the eardrum perforates; if this happens a doctor should prescribe antibiotics but there is normally no long term damage.

Before flying, we strongly recommend seeing your GP who may prescribe some decongestant medication.

Eating and drinking during take-off and landing will help open your child’s eustachian tubes and prevent discomfort. Ear plugs known as ‘EarPlanes’ (available from pharmacies) can help to reduce discomfort from changes in air pressure.

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Glue ear resources and further reading

  • Glue ear poster

Advice for Parents and Professionals on Glue Ear

Download:  Glue ear poster

  • Treatments for glue ear factsheet

Information about alternative treatments for glue ear, other than using grommets.

Download: Treatments for glue ear

  • How glue ear affects speech

I CAN, a children's communication charity, provides a factsheet written by speech and language therapists about the impact of glue ear on a child's speech. 

Download: My Child Has Glue Ear... How Will this Affect Their Talking?

  • Harvey gets grommets comic

Front cover

A short comic book story about a young boy who gets grommets. Aimed at children under 10.

Download or order:  Harvey gets grommets

  •   Glue ear videos

For some further information about glue ear and to watch an animation of how glue ear affects the ear visit the NHS Choices website.

A family tell us about their son's grommet operation and ongoing hearing problems

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