Glue ear in childhood

Glue ear and other hearing problems in children

What is Glue-ear?

Otitis Media or Hearing loss in children can be common.

Hearing problems in children can have a significant impact on their development, communication, and overall well-being. One of the most common conditions affecting younger children is glue ear, also known as otitis media with effusion (OME). This article focuses on glue ear, its symptoms, causes, and treatments, with a brief overview of ear infections as another related issue.

When does glue ear occur?

Glue ear occurs when thick, sticky fluid builds up in the middle ear, leading to temporary hearing loss. Unlike a typical ear infection, glue ear is usually not accompanied by pain or fever, though it can still affect a child’s ability to hear.

This condition is particularly common in children between the ages of 1 and 8, with the highest incidence occurring in children aged 1 to 5. This is due to the immaturity of their Eustachian tubes, which are not yet as efficient at draining fluid from the middle ear as they should be.

Symptoms of glue ear

While glue ear may not always cause noticeable pain or discomfort, there are several signs that parents should be aware of. The symptoms of glue ear can include:

Hearing difficulties

Children with glue ear may have trouble hearing conversations, which might manifest as frequently asking for repetition, turning up the volume on the TV, or appearing unresponsive to sounds. This can sometimes be mistaken for inattentiveness or distraction.

Speech and language delays

The hearing loss caused by glue ear can hinder speech development and language acquisition. As hearing is crucial for language learning, children may experience delays in speaking or forming sentences, which could also impact their academic progress.

Behavioural changes

Children may exhibit frustration, irritability, or withdrawal due to their difficulty in hearing. In some cases, they may become more inattentive, not responding to questions or commands as they struggle to hear what is being said.

Balance issues

Since the middle ear plays a role in maintaining balance, glue ear can sometimes cause children to feel unsteady or have difficulty with coordination. This may lead to accidents or a lack of confidence in physical activities.

Recurring ear infections

Although glue ear is not the same as an active ear infection, it can often follow repeated ear infections. The fluid buildup in the middle ear may become more persistent after multiple infections, leading to ongoing issues with hearing.

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What causes glue ear?

Several factors can contribute to the development of this condition.

  • One of the most common causes is frequent colds or respiratory infections. These infections can block the Eustachian tubes, which are responsible for draining fluid from the middle ear, leading to a buildup of fluid.
  • Allergies can also play a role, as they often lead to increased mucus production, which can further contribute to fluid accumulation.
  • Another significant factor is exposure to second-hand smoke, which has been linked to a higher risk of glue ear in children.
  • Additionally, some children may be more prone to developing glue ear due to a family history, suggesting a genetic predisposition.

Diagnosing glue ear

Diagnosing glue ear typically involves a visit to a healthcare professional. During the examination, a doctor may use an otoscope to look inside the ear canal and check for signs of fluid or abnormalities in the eardrum.

Another common diagnostic test is tympanometry, which measures how the eardrum moves in response to changes in air pressure. This can help identify any fluid in the middle ear. In some cases, hearing tests, such as audiometry, may be used to assess the extent of any hearing loss.

Glue ear treatment

In many cases, glue ear will resolve on its own within a few months, especially in mild instances. However, if the condition persists or is particularly severe, treatment may be needed to prevent any long-term developmental delays.

Common treatments for glue ear include:

Watchful waiting

For mild cases, healthcare providers may recommend simply monitoring the condition over time to see if it improves naturally.

Hearing aids

In cases of significant hearing loss, hearing aids may be used as a temporary solution to help children hear while glue ear persists.

Grommets (ventilation tubes)

These small tubes are surgically inserted into the eardrum to allow air to enter the middle ear and help drain the fluid. Grommets are particularly useful for children who experience recurrent or long-lasting glue ear.

Medications

While antibiotics are rarely helpful in treating glue ear, if allergies are identified as a contributing factor, antihistamines or nasal sprays may be prescribed.

Autoinflation devices

These special devices help children open their Eustachian tubes by encouraging them to blow gently into a balloon through their nose, which can promote fluid drainage.

Ear infections in children

In addition to glue ear, ear infections, such as acute otitis media, are another common cause of hearing problems in children.

Ear infections often cause severe ear pain, which may be accompanied by tugging at the ears. They can also lead to fever and irritability, particularly if the infection is bacterial. Temporary hearing loss can occur due to fluid or swelling in the ear. Treatment typically involves antibiotics for bacterial infections, over-the-counter pain relief medications like ibuprofen or paracetamol, and, in some cases, surgical intervention such as grommets if infections become frequent.

Supporting your child

As a parent, it is essential to provide support to your child if they are experiencing hearing issues, including glue ear. Encouraging good communication by speaking clearly, facing your child when talking, and minimising background noise can help them understand and respond better. Informing teachers about your child’s condition ensures they receive the appropriate classroom support, and providing a quiet learning environment can help your child concentrate better if their hearing is affected. Regular check-ups with a healthcare provider are also crucial to monitor your child’s condition and adjust treatment if necessary.

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Glue ear is a common and often temporary condition that can impact a child's hearing and development. While most cases resolve naturally, persistent cases require early recognition and appropriate treatment to prevent long-term consequences. Ear infections, another frequent cause of hearing problems in children, should be managed promptly to avoid complications. If you suspect your child has glue ear or any other hearing-related issue, it is important to consult a healthcare professional for advice and support.

FAQs on glue ear in children

What does glue ear look like?

Glue ear may not always be visible externally, as it primarily affects the middle ear. However, during a medical examination, a healthcare professional may observe a dull or retracted eardrum, which can indicate fluid buildup behind it. The eardrum might also appear less mobile when tested, which is a sign of fluid or pressure in the ear.

Is glue ear hereditary​?

Glue ear can sometimes run in families, suggesting a genetic predisposition. If a child’s parents or siblings have had glue ear or other ear problems, the child may be more likely to develop it as well. However, environmental factors, such as frequent infections or exposure to second-hand smoke, also play a significant role.

Can adults have glue ear?

While glue ear is most common in young children, adults can sometimes experience it, particularly if they have a history of ear problems or conditions that affect the Eustachian tubes. However, it is less frequent in adults, as their Eustachian tubes tend to be more developed and efficient at draining fluid from the middle ear.

Can glue ear cause permanent hearing loss​?

In most cases, glue ear causes only temporary hearing loss due to fluid buildup in the middle ear. However, if the condition is not treated or becomes recurrent, it can potentially lead to more long-term hearing issues. Persistent glue ear over time, particularly in young children, can sometimes result in permanent hearing loss, especially if it affects speech development.

Can you fly with glue ear?

It is generally safe to fly with glue ear, but it may cause discomfort due to the changes in air pressure during the flight. The pressure fluctuations can affect the ear’s ability to equalise, leading to a feeling of fullness or pain in the ear. If you're flying with a child who has glue ear, you can try encouraging them to swallow, yawn, or chew gum (if they're old enough) to help relieve the pressure.

Is glue ear painful​?

Glue ear is usually not painful, which is one reason why it can be difficult to detect. Unlike typical ear infections, it does not typically cause sharp or severe pain. However, some children may experience a feeling of fullness or pressure in the ear.

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