What is the treatment for glue ear?

Watchful waiting ('wait and see')
No treatment is usually advised at first as the outlook is good. The length of time advised to 'wait and see' can vary, and may depend on certain factors. For example, whether the glue ear is recurrent or new, the severity of the hearing loss, the age of the child, etc. For a 'typical' situation, a doctor may advise that you wait several months to see if the glue ear clears.

Balloon treatment
For this treatment a special balloon is blown up by the child using their nose. This is called 'autoinflation'. It puts back-pressure into the nose, and may help to open up the Eustachian tube and allow better drainage of the fluid. The child needs to do this regularly until the fluid clears. The research studies that looked into this treatment found that it seems to help in some cases, but not all. Also, this balloon treatment requires a lot of commitment to do regularly. It is also difficult for young children to do properly. Therefore, with well motivated older children who can use the device, it may be worth a try. It is not thought to cause any side-effects or problems. You can get an autoinflation kit called Otovent on prescription, or you can buy it from pharmacies.

Surgery
A small operation may be advised by an ear specialist if glue ear persists, or is severe. This involves making a tiny cut (about 2-3mm) in the eardrum under anaesthetic. The fluid is drained and a grommet (ventilation tube) is then usually inserted. A grommet is like a tiny pipe that is put across the eardrum. It helps to drain any fluid, and lets air into the middle ear. Hearing improves immediately.

Grommets normally fall out of the ear as the eardrum grows, usually after 6-12 months. By this time the glue ear has often gone away. The hole in the eardrum made for the grommet normally heals quickly when the grommet falls out. Sometimes grommets need to be put in on more than one occasion if glue ear recurs. (See a separate leaflet called 'Operations for Glue Ear'.)

In some cases, the adenoids are also taken out to improve the drainage of the Eustachian tube. Adenoids are small clumps of glandular tissue (similar to tonsils). They are attached at the back of the nose cavity near to the opening of the Eustachian tube.

What can I do for my child with glue ear?

The main thing is to be aware that your child will have dulled hearing until the condition goes away or is treated. The following are some tips.

• Talk clearly and more loudly than usual (but you don't have to shout).
• Attract your child's attention before speaking to him or her. Talk directly face to face, and down at their level.
• Cut out background noise when you talk to your child (for example, turn off the TV or radio).
• Understand that your child`s frustration or bad behaviour may be due to dulled hearing.
• Discuss the problem with the teacher if your child is at school or nursery. Sitting near to the teacher may help. Often in a class there are several children with glue ear, and raising awareness of glue ear with teachers is helpful.
• Don't let anybody smoke in the same home as your child.

Even after an episode of glue ear has cleared up, remember the problem may return for a while in the future, particularly after a cold or ear infection.

Does glue ear go away?

As children grow older, problems with glue ear usually go away. This is because the Eustachian tube widens, and the drainage of the middle ear improves. In general, the older the child, the less likely fluid will build up in the middle ear. Also, in older children, any fluid that does build up after a cold is likely to clear quickly. Glue ear rarely persists in children over the age of eight. In nearly all cases, once the fluid has gone, hearing returns to normal. Rarely, long-term glue ear may lead to middle ear damage and some permanent hearing loss.

Some common questions about glue ear

Can glue ear be prevented?
The cause of glue ear is not fully understood, and there is no way of preventing most cases. However, the risk of developing glue ear is less in children who live in homes free of cigarette smoke, and who are breast fed.

Are children routinely checked for hearing?
Yes. All children should have a routine hearing test either shortly after birth or aged about 8-9 months. However, most cases of glue ear develop in children aged 2-5 years. Therefore, hearing may have been fine at the routine hearing test, but then become dulled at a latter time. See a doctor if you suspect your child has dulled hearing at any age.

Can medication clear glue ear?
Various medicines have been tried to help clear glue ear. For example, antihistamines, steroids, decongestants, antibiotics, and medicines to 'thin' mucus. However, research studies have shown that none of these medicines are much use in the treatment of glue ear.

In summary

• Glue ear is common in young children. It causes dulled hearing.
• In most cases it goes away by itself within a few weeks or months.
• Some children have two or more episodes of glue ear, but it is rarely a problem after the age of 7-8 years.
• A balloon that is blown up by the nose may help some older children who are able to use it.
• An operation to drain the fluid and insert grommets may be advised if glue ear persists or is severe.

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