Treating glue ear
Most cases of glue ear will clear up by themselves, but a temporary hearing loss as a result of a prolonged episode of glue ear can affect a child’s speech and language development and you may also notice a change in their behaviour.
You should take your child to see your GP who will examine your child’s ears and see if they have glue ear. Your GP may monitor your child to see if the glue ear resolves by itself. If it doesn’t, your GP will refer your child to the audiology or ear, nose and throat (ENT) department at your local hospital for a hearing test.
If your child is diagnosed with glue ear and their hearing is affected, the audiology or ENT department at the hospital will monitor the glue ear over a period of three months. This is known as ‘watchful waiting’. At the end of this period, your child’s hearing will be retested to see if the glue ear has resolved.
If there’s no improvement, surgical intervention, such as grommets, or hearing aids may be offered.
Grommets are tiny plastic tubes that are put in the eardrum. They allow air to circulate in the middle ear and help to reduce the fluid from further building up. This is usually done as a day case and is 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. After this time there shouldn’t 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 for around 6–12 months until the eardrum has healed and pushed them out. Sometimes the fluid comes back and another grommet operation may be considered.
Our comic for children under 10, Harvey Gets Grommets, explains why Harvey gets grommets, what happens when he visits the doctor, and what happens at the hospital when the grommets are put in.
Swimming and bathing with grommets
Your ENT doctor will recommend keeping your child’s ears dry for the first 2–4 weeks immediately following the surgery. After this, most children with grommets don't need to take any special precautions and can swim and bath as usual with grommets in. There are a few children who may be at a particular risk of infection due to water entering the ear. If your child is one of these, your ENT doctor may suggest some of the following precautions.
- 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.
- Use earplugs and neoprene headbands, such as the Ear Band-It.
- Try to get your child to wear a swimming cap.
- 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.
- Be careful when washing your child’s hair. Soapy water is able to slip more easily through the grommet into the middle ear. If the water is dirty it will infect it. With your child sitting upright in the bath, wash their hair first before body washing. Tilt their head back and rinse with clean water, then apply a shower cap. This way your child can play in the bath without getting dirty, soapy water in their ears.
The Otovent nasal balloon (also known as nasal balloon autoinflation) is a non-surgical, drug-free treatment option for glue ear. Autoinflation is a method of encouraging the eustachian tube to open. This can help drain the ear naturally through the eustachian tube, by forcing air from the back of the throat to the middle ear.
The Otovent is suitable for children from three years old. It consists of a balloon and a nosepiece. This treatment involves fitting the balloon to the nosepiece, putting the nosepiece against one nostril and keeping the other nostril and mouth closed. By blowing through the nostril, the balloon is inflated until it’s about the size of a grapefruit. The nosepiece is removed and the procedure repeated with the other nostril.
The Otovent may be helpful for some older children during the watchful waiting period or while waiting for grommet surgery.
Otovents are available on prescription. Ask your GP or ENT consultant about whether they think it will be suitable for your child.
Hearing aids are devices designed to make sounds louder. They are used on a temporary basis for glue ear while waiting either for the glue ear to resolve or for grommet surgery. For children who have repeated problems with glue ear or are unable to have grommet surgery, hearing aids can be very helpful.
Good quality, digital hearing aids are available free of charge for all children on the NHS. Your child may also be offered a bone conduction hearing device.
Read about Cody who still has glue ear at the age of 12.
In 2008, the National Institute for Health and Clinical Excellence (NICE) published guidance about treatments for glue ear for the NHS in England and Wales. NICE currently recommends grommets or hearing aids as effective treatments.
For some treatments, there may be very little or poor quality evidence available. Some may also be offered by the alternative or complementary health sector, which doesn't tend to produce the type of scientific evidence reviewed by NICE.
They found the following treatments to be ineffective or lacked sufficient evidence to be formally considered effective.
It’s believed that your child’s diet can affect the amount of mucus their body produces. Dairy products (made from cow’s milk) and a high amount of sugar in a child's diet can increase the amount of mucus the body makes. A build-up of mucus may be a cause of glue ear. It’s important that a child has a balanced diet. If you think it may help to reduce the amount of cow’s milk in your child’s diet but you’re worried about your child lacking calcium, consider alternatives, such as broccoli, which are naturally high in calcium and calcium-enriched dairy alternative products. Always ask your GP for advice before changing your child’s diet.
Eating more healthy food with plenty of fresh fruit and vegetables, grains and lean meat or fish may help. You can also ask to see a registered dietician.
Homeopathy is a type of care used to treat a wide range of conditions, including glue ear. It may help to stimulate the body’s own immune system by using tiny doses of natural substances. It’s often used to complement other forms of healthcare. However, NICE doesn't recommend homeopathy as a way of managing glue ear.
For more information, contact the British Homeopathic Association at:
49-51 East Road
All doctors who are listed practitioners with the British Homeopathic Association are registered with the General Medical Council and have undertaken training in homeopathy at a faculty-accredited postgraduate teaching centre.
Osteopathy is a system of diagnosing and treating conditions, concentrating on the body's structure. This treatment can help to realign muscle tissue, bones and joints, allowing the body to function effectively and in doing so, may relieve pain and ailments.
For information about osteopathy and to find a registered osteopath who specialises in treating children in your area, contact the General Osteopathic Council. The General Osteopathic Council registers qualified osteopaths and sets standards of osteopathic practice and conduct. Their aims are to protect patients, to develop the osteopathic profession and promote an understanding of osteopathic care.
Phone: 020 7357 6655 (voice)
The line is open between 9am and 5pm, Monday to Friday
The Osteopathic Centre for Children (OCC) is a registered charity that offers osteopathic treatment to children up to the age of 18 for a wide range of conditions. The OCC has clinics in London. For more information contact:
The Osteopathic Centre for Children (London)
22a Point Pleasant
Phone: 0208 875 5290 (voice)
The line is open between 9am and 5.45pm, Monday to Friday
Email: [email protected]
Xylitol is a plant-based product, which is usually used as a sweetener in food. It’s lower in calories than sugar and can be used by diabetics. Xylitol has been shown to inhibit the type of bacteria that can be a cause of tooth decay and ear infections.
Clinical trials have shown that xylitol-based chewing gum, when used regularly, may reduce ear infections and glue ear.
In the UK, xylitol can be found in small amounts in some types of chewing gum, children's vitamins and toothpaste. Other xylitol products currently available in the United States include granules, nasal sprays and sweets. A nasal spray containing xylitol has been developed and is available from health food and vitamins and supplements suppliers and online.
For more information, talk to your GP or ENT consultant. There is also a US website www.xlear.com with more information. On this site, you can also read about the history of xylitol and its effects.
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