Glue ear or also known as middle ear effusion or Otitis Media, occurs when an excessive build-up of thick mucus fluid becomes trapped behind the ear drum in the middle ear cavity where the tiny little bones of the middle ear (the ossicles) live. This cavity is usually an air filled cavity which allows the ear drum and the bones of the middle ear to move freely. If fluid becomes trapped in this cavity it prevents sounds from vibrating the ear drum properly and in turn passing through to the organ of hearing “the cochlea”, thus temporarily effecting how we hear.

One of the most common causes of hearing problems in children, Glue ear occurs more frequently in boys than girls due to the slower development of the Eustachian tube. It is such a common problem yet so many people are unaware of it and what to do about it. Even if your child passed the post natal screening test, they can very quickly develop a temporary conductive hearing loss such as Glue Ear.

The diagnosis and treatment of Glue Ear is vital to reduce the possibility of learning difficulties and speech delays as hearing levels are usually effected whilst the fluid is present in the middle ear. An individual’s hearing can be reduced by 40dB+ which is the equivalent of putting your fingers or thick cotton wool in the ears making most sounds quite muffled and distorted.

Glue Ear occurs either due to bacteria forming in the middle ear from a common cold or flu (more often a middle ear infection) or fluid that naturally builds up in the middle ear cavity that is unable to drain away properly simply due to the "immaturity" of the Eustachian tube. The Eustachian tube is effectively a ventilation tube that runs from the middle ear down to the back of the throat and in small children is often quite narrow and lays more flat/horizontally across the face. As the child develops it widens and tilts in a more vertical direction - this sometimes can take up to 10 years to develop properly.

Children who have frequent runny noses or problems with enlarged adenoids that are prone to regular infection are also prone to Glue Ear due to the proximity of the adenoids to the opening of the Eustachian tube. Children who are teething will often also present with Ear infections.

• The individual appears not to be listening or is easily distracted
• Frequently says “Huh” or “what” or needs things repeated a number of times
• Pulls at their ears or plays with their ears more frequently
• Sleep is disrupted and is more grizzly or unsettled than usual due to pain when laying down
• Has a frequent runny nose that is often coloured; but can be just clear
• Is a little more off balance than usual or wobbly on their feet when walking
• Demonstrates behavioural issues, is more disruptive

If you notice any of the above symptoms or are just generally concerned with your child’s ears and / or hearing, I recommend you either see your doctor to have their ears checked or make an appointment to see an Audiologist.

Audiologists are able to perform a very quick, simple yet accurate assessment of the function of your child’s middle ears by performing a test called tympanometry. An Audiologist is also best placed to perform a hearing assessment to measure your child’s peripheral hearing.

The usual treatment for Otitis Media in the short term is a course of antibiotics. This is often an effective treatment however long term use of antibiotics is not ideal and isn't really addressing what the underlying problem may be. In cases where fluid build-up is recurrent over a number of months, a referral to an Ear Nose & Throat (ENT) specialist is recommended. The ENT will be able assess the possible cause of the recurrent or chronic fluid build-up and will be able to recommend the best course of action depending on the number of infections over a period of time.

In some instances the use of "grommets" may be recommended. These are very small ventilation tubes (look like an 'o' ring) which are surgically inserted in to the ear drum to allow air flow in to the middle ear to prevent bacteria from growing and also as a point to allow excess fluid to drain. Importantly, this will restore a child’s hearing back to normal limits allowing them to develop their speech and learning milestones again.

The grommet stays in the ear drum usually for a minimum of 6 months and can remain there for up to 2 years. The body will eventually expel the grommet from the ear drum on its own. On the rarer occasion they may need to be surgically removed.