Glue ear

Glue ear happens when the middle ear (behind the eardrum) becomes filled with sticky fluid. The medical name for glue ear is otitis media with effusion (OME). Glue ear is very common and is often linked with ear infections. At any one time, 1 in 5 pre-school children have glue ear.

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. Children and people with certain conditions, such as Down’s syndrome, usually have smaller eustachian tubes, which means they become blocked more easily. The cells lining the middle ear produce fluid, but if the eustachian tube becomes blocked, air cannot enter the middle ear and the fluid starts to build up. This is usually a clear, runny liquid, but it can get thicker and block the middle ear, leading to glue 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. It can be like listening to the world with your fingers stuck in your ears. Glue ear can affect one or both ears.

Glue ear is usually temporary, but some children may experience long-term glue ear and fluctuating levels of hearing loss.

Visit the NHS website to watch a video explaining what glue ear is and how it's treated.

Many things can contribute to glue ear, such as colds and flu, allergies, and being around people who smoke. Glue ear is often but not always linked with ear infections. 

Children with cleft palate, or with genetic conditions such as Down's syndrome, may be more likely to get glue ear if they have eustachian tube dysfunction. This could be because they have smaller eustachian tubes or because the muscles that help to open the eustachian tubes may not function well.

Breastfeeding

Research suggests that breastfeeding may reduce the risk of babies and young children developing glue ear. It’s thought that breast milk contains proteins which can help stop inflammation and protect against glue ear even when breastfeeding has stopped. Ask your GP (family doctor) or health visitor for more information.

Smoke-free environment

Research carried out by the Department of Health shows that children are more likely to get ear infections and glue ear if they’re often in a smoky environment. A child is likely to experience glue ear for as long as the environment remains smoky.

Try to make your children’s environment smoke-free by asking people who smoke to smoke outside, away from your child. It is not enough to just open a window, as dangerous smoke particles will stay in the air.

Get NHS support to stop smoking.

Allergies

Research suggests that some children may develop persistent glue ear because of allergies. Allergies to fur, pollen, dust mites or some foods may cause the eustachian tube to swell and can contribute to enlarged tonsils and adenoids. This can prevent fluid from draining from the middle ear.

If you think your child’s glue ear might be related to allergies, ask your GP about testing your child for allergies or referral to an NHS allergy clinic. For more information on allergies, contact Allergy UK.

The following are common signs of glue ear.

• Not responding when called
• Using a louder voice than previously
• Changes in behaviour, such as becoming more withdrawn or angry
• Becoming tired and frustrated
• A lack of concentration
• Preferring to play alone

These signs can often be mistaken for stubbornness, rudeness or being naughty. You could ask your child’s teacher, or other people your child has had recent close contact with, if they’ve noticed any of these signs.

Persistent glue ear can affect a child’s speech and language development. For example, parts of words may not be pronounced clearly. They may also fall behind at school if they don’t have extra support.

Children who are already deaf can still develop glue ear, which can cause additional hearing loss. If your child suddenly cannot hear sounds they could hear previously, this may be a sign that they have glue ear in addition to their deafness.

Arrange an appointment with your GP. Glue ear is often 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 they have glue ear. They may describe your child’s ear or ears as ‘congested’. If there’s any pain or sign of infection, your GP may prescribe a course of antibiotics.

Your GP, health visitor or school nurse should refer you to the audiology or ear, nose and throat (ENT) department at your local hospital.

An audiologist will examine your child’s ears and carry out an assessment.

A hearing test will be done to check if the glue ear is affecting your child’s hearing. Different types of hearing tests are used depending on the child’s age and level of development. These usually take the form of games involving play.

If possible, the audiologist will also do a tympanometry test, which measures how well the eardrum can move. If there is fluid in the middle ear the eardrum will not move properly. A graph (called a tympanogram) will show the results of this straight away. The test is quick and painless.

The audiologist should explain the results of all the tests and discuss the options for your child. For most children, there will need to be a period known as ‘watchful waiting’. This means monitoring the glue ear with repeated tests at least three months apart. This is important, as for most children, glue ear will clear up in this time. If your child’s glue ear doesn’t clear up, they may be offered temporary hearing aids, or an ENT doctor may recommend grommets (small tubes inserted into the eardrum during a minor surgery).

Many families across the UK are experiencing long waiting times for audiology and ENT services. Ask your GP or audiologist about local waiting times and how to best support your child in the meantime.

While your child has glue ear, there are some simple things you can do to make listening easier for them.

• Get your child’s attention before you start talking.
• Face your child as much as possible and keep eye contact.
• Keep background noise to a minimum.
• Speak clearly, without shouting, and maintain your normal rhythm of speech.

Your child’s teacher may notice that your child is having problems but not realise this is because of their hearing. Tell your child’s teacher about their glue ear so that arrangements can be made in school to help them.

Hear Glue Ear is an organisation which supports children and families affected by glue ear. They produce resources such as downloadable glue ear passports and care plans which you can fill in and share with your child’s nursery or school.

Generally, children with glue ear don’t have any problems flying, although sometimes doctors do not 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 landing due to changes in cabin pressure, causing discomfort. There is a small risk that the fluid could expand so much, the eardrum perforates. If this happens a doctor should prescribe antibiotics, but there’s normally no long-term damage.

Before flying, we strongly recommend seeing your GP who may prescribe decongestant medication. They can check your child’s ears and let you know if there’s any reason why they shouldn’t fly.

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

Flying with grommets is safe. The grommets prevent the discomfort caused by changes in cabin pressure, so your child will be comfortable during take-off and landing.

NHS England have produced a decision support tool for parents and carers of children with glue ear. The tool is designed to empower parents to make sure their children get the right support.

Download the Hear Glue Ear app, designed to help children aged two to six who are experiencing hearing loss due to glue ear.

Join our glue ear Facebook group to chat to other parents of children experiencing glue ear.