What is Glue Ear?

Glue ear, resulting from a middle ear infection, is one of the most common medical conditions experienced by young children. This guide explains what glue ear is, how it develops, the signs and symptoms, and how it is treated.

What is glue ear?

Glue ear (also known as otitis media with effusion) occurs when the space in your middle ear becomes filled with a glue-like substance, blocking air and sound from entering the middle ear and moving through the Eustachian tube, which runs down towards your nose.

Often glue ear develops when you have been unwell and suffering with congestion. When we are well, our sinuses are clear, moving air around and draining mucus. When we have a lot of congestion, excess mucus can get trapped in the Eustachian tube and the middle ear cavity.

Without a clear cavity in your middle ear, sound can’t resonate or vibrate, resulting in problems with hearing, and sometimes pain or discomfort. It’s a bit like trying to hear underwater — everything is just a bit muffled and distorted.

Adults and older children can suffer from glue ear, but it is far more common in young children because of their smaller Eustachian tubes. The smaller the diameter of the tube, the harder it is for fluid to drain out.

Symptoms of glue ear

Because some symptoms of glue ear are common to other conditions, it isn’t always easy to tell whether your child might have glue ear or something else. Healthdirect lists these symptoms to look out for:

• Loss of appetite
• Tugging or rubbing ear
• Pain when lying down on one side
• Grumpiness or fussiness
• Discharge from the ear
• Fever or inflammation
• Loss of balance

There may also be other tell-tale signs, such as asking you to repeat things, turning the TV up, or struggling to hear when there is background noise.

Often children with glue ear are mistakenly diagnosed as being difficult or going through a “naughty phase” when they are actually missing social cues or trying to compensate for not being able to hear properly. This can be particularly problematic if it coincides with a child starting school or kindy, impacting speech and language development.

Triggers and risk factors

Glue ear often develops as a result of congestion from a cold or infection. It can also be more prevalent in children with siblings at school or day care, because they’re exposed to more bugs and illnesses. Children who live with a smoker, or suffer from seasonal allergies, may also be more prone to glue ear.

You can lower your child’s risk factor by encouraging them to practise good hygiene, and studies have shown that being fully vaccinated helps too. For the little ones, some research suggests that breastfeeding can reduce the occurrence of glue ear, and limiting the use of pacifiers may help as well.

Treatments for glue ear

GPs often suggest a “wait and see” approach for glue ear, to give it time to resolve itself. If after around three months there are still signs of glue ear, or of infection, pain or hearing difficulties, your doctor may suggest further treatment such as the insertion of grommets (ear tubes).

In this very common and quick procedure, a small plastic tube is inserted under general anaesthetic into the middle ear. This tube helps the fluid escape the middle ear cavity and allows sound to travel in.

Generally, the tubes fall out by themselves within 12 months as the eardrum rejects them. Sometimes a repeat procedure is required, but usually just one set of grommets is enough to see the child through until the Eustachian tube has grown big enough to deal with fluid on its own.

The surgical procedure usually takes around 20 minutes and is generally done as a day procedure. Around 30,000 grommet insertion procedures take place in Australia each year.

How to help your child while they have glue ear

If your doctor has suggested the “wait and see” approach, try some of these tips from the Royal Children’s Hospital Melbourne and KidsHealth:

• See if your child is more comfortable sitting up, or sleeping with their head elevated — this may help fluid to drain.
• Try gentle massage around the outer ear to loosen up the fluid and provide relief from pressure.
• Speak to your child clearly and directly, using eye contact.
• Be aware of background noise as it may be impeding your child’s ability to hear clearly.
• Try to eliminate possible triggers such as allergy-inducing dust or pollen.
• Talk to their teacher and explain that your child is finding it hard to hear and may need extra assistance, such as sitting closer to the front.

Checking your child’s hearing

The Sound Scouts app tests for conductive hearing loss — the type associated with glue ear. If you suspect your child may have glue ear, you can use Sound Scouts to check if their hearing is affected, and then repeat the test during the “wait and see” period and again after recovery to compare results.

Sources: ASHA, Aussie Deaf Kids, Healthdirect, Healthline, KidsHealth, Royal Children’s Hospital Melbourne.