Glue ear

Symptoms of a glue ear 

The medical term for glue ear is otitis media with effusion (OME).

The most common sign of glue ear is hearing loss, which can affect one or both ears.

If your child is struggling to hear, they may:

• have difficulty understanding people who are far away
• speak quietly or have delay in developing speech
• appear unusually tired or irritable, because they have to try harder to listen to things
• have problems picking out conversations in places where there's a lot of background noise
• easily "tune out" of conversations when they're distracted
• only be able to understand face-to-face conversations that take place at a short distance
• experience problems with communication and learning, and social skills (these problems will usually resolve once normal hearing is restored)

Less common symptoms 

Less common symptoms of glue ear include:

• episodes of mild ear pain or repeated infections
• popping sensation
• discharge from the ear
• irritability
• problems sleeping
• balance problems and clumsiness
• tinnitus  
• delayed speech and language development in younger children, if the condition lasts a long time

When to seek medical advice 

It's important to see your GP if you're concerned that your child may be having hearing problems.

While glue ear is usually the most common cause of hearing loss in children, further tests may be needed to rule out other possible causes.

Causes of glue ear 

The exact cause of glue ear is unknown, but over half of all cases are thought to follow an acute ear infection (otitis media). If symptoms persist, it can be because of ongoing infection, or a problem with the Eustachian tube.

The Eustachian tube is a narrow tube that runs from your middle ear to the back of your throat. Its two main functions are:

• to ventilate your middle ear, helping to maintain a normal air pressure within it – sudden changes in air pressure can be painful and can damage the ears (changes in air pressure can cause the popping sensation many people experience on an aeroplane)
• to help drain away mucus and other debris from the ear – the middle ear can often become clogged with mucus caused by inflammation, infection or an allergic reaction

With glue ear, the Eustachian tube seems to lose the ability to drain away the mucus. The mucus builds up inside the ear, which leads to glue ear. 

It's thought that problems with the Eustachian tube may be caused by things like a previous ear infection, smoke irritation or allergies. Glue ear isn't caused by a build-up of ear wax, or by getting water in the ear after swimming or showering.

Other factors that are also thought to increase the risk of getting glue ear include:

• growing up in a household where adults smoke
• being bottle-fed rather than breastfed as a baby
• having siblings (brothers and sisters) who've had the condition

Treating glue ear 

Most cases of glue ear don't require treatment as the condition will improve by itself, usually within three months.

Treatment is usually only recommended when:

• symptoms last longer than three months
• the hearing loss is thought to be significant enough to interfere with a child's speech and language development

In these circumstances, glue ear can usually be treated using minor surgery, which involves placing small tubes (grommets) in the ear to help drain away the fluid.

Complications of glue ear 

Possible complications of glue ear include ear infections and, where hearing loss is more severe, a minor temporary delay in speech and language development.

If left untreated for a long period of time, glue ear can sometimes cause damage to the ear drum (tympanic membrane) requiring surgery.

Some of the problems associated with glue ear get better by themselves quite quickly, although further treatment may occasionally be necessary.

Adults with glue ear 

Glue ear can occasionally develop in adults. It's diagnosed and treated in much the same way as children.

If symptoms show no signs of improving after about three months, grommets can be put inside the ear to drain the fluid from it.

Rarely, glue ear in an adult is caused by a tumour at the back of the nose. If you are an adult who develops glue ear, you should be referred to an Ear, Nose and Throat (ENT) specialist. Often, no particular cause is found.

• Glue ear

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