As well as the visible, outer parts, each ear has middle and inner parts. Glue ear mainly affects the middle part. Each ear looks like this

image supplied by requester, copyright cleared, compare the two images and let me know which works best for you...

(image found on freepik.dom, free license - maybe too much detail but the best I could find that was also colourful)

Sounds travel into the ear along the ear canal and make the eardrum vibrate. These vibrations are passed along the three small bones inside the middle ear to the inner ear. (The middle ear is the space behind the
eardrum.) The inner ear sends messages along the auditory nerve to the brain, allowing us to hear. Near the bottom of each middle ear space is a tube called the eustachian tube. It connects the ear to the back of the nose. This tube lets air into the middle ear, keeping it aired and healthy. The air allows the eardrum to move
freely. How does glue ear happen Glue ear happens when fluid collects in the middle ear space of one or both
ears.

After a cold or infection in the throat or ear, one or both eustachian tubes can be blocked. When this happens, the air pressure inside the middle ear space drops. Fluid from the cells in the lining of the middle ear then fills up the middle ear space. The fluid is often just a runny liquid. It may though become thicker, like glue. Hence the name "glue ear". When this happens, the eardrum cannot move as freely. It does not send vibrations into the inner ear easily. The child may then have a hearing problem.

It is very common. About four out of every five children have at least one episode, before their fourth birthday. Usually this will get better without any treatment.

What can be done about persistent glue ear?

Your child has been referred to the ENT (Ear, Nose and Throat) department.

The consultant has asked you questions about your child's ear problem, and examined the ear by looking into it with an otoscope
An audiologist has carried out a hearing test to see how well your child hears, and a tympanogram to see if there is fluid in the ear Treatments for persistent glue ear

1. Surgery - putting in grommets.

Under a light general anaesthetic, a tiny cut is made in the eardrum. The fluid is drained away and a small tube is put through the small hole that the surgeon has made. This tube is commonly called a grommet. It is also known as a ventilator, ventilation tube or 'vent'. The small hole in the grommet keeps the middle ear aired and healthy.

Usually, this operation does not involve an over night stay in hospital. The doctor will explain to you what will happen. The grommets will stay in place for about six months. When they fall out, the small hole in the eardrum will usually heal quickly.

For many children, one set of grommets is all that is needed. For some, the glue ear may come back and another set may need to be put in.

2. Observation - including medical management

Glue ear does clear up on its own. This treatment means keeping a close watch on your child's ears. This will be done by examination and doing hearing tests at regular intervals. The doctor will give you medicines if he or she thinks these will help. For example, the doctor may prescribe antibiotics if your child gets an ear infection.

In some children, the glue ear may clear up after a short time. In others it may take longer.

It is not yet possible to say in advance how a particular child's glue ear may change. Observation is therefore an important part of treatment.

3. Surgery - putting in grommets and taking out the adenoids

As well as putting in grommets as described above, the child's adenoids are taken out. These may affect the functioning of the eustachian tubes. This operation is done at the same time as putting in the grommets. It may mean that the child has to stay in hospital over night.

4. Hearing aid

It is not clear whether one treatment is better than the others. Each is safe and will help the child. A particular treatment will probably suit some children better than others. It is not yet possible to know this in advance for each child. Putting in grommets improves the child's hearing straight away. For some children, the hearing problem may return when the grommet falls out. In these cases, another set may need to be put in.

Doctors generally want to avoid putting in too many sets of grommets. Each grommet can leave a tiny scar on the ear drum. Occasionally, there is a discharge from the ear after the operation. This usually clears up after
treatment with antibiotic drops. 

The ears should be kept dry when the grommets are in place. Swimming with ear plugs is acceptable. A few children will find that everything sounds too loud for a short time after the operation. Observations with medical treatment avoids an operation.

The ENT Specialist will examine your child to see:

• how glue ear is affecting him or her, and,
• what, if any, hearing difficulties he or she is having

 
Your child may learn to cope with glue ear. Most cases of glue ear will eventually get better on their own. The doctor will see how quickly this is happening. Taking out the adenoids may reduce the need for extra sets of grommets. It may also help the child's general health in the long term. However, this effect is not certain.

An overnight stay may be needed after this operation. This may be inconvenient for the family and child. There is also a risk of serious bleeding.

1. Stop smoking - passive smoking causes glue ear.
2. Remind yourself and others constantly that your child's hearing may be less than perfect. If your child seems to be having difficulty hearing, you can help by doing the following.

Borders General Hospital
Melrose
TD6 9BS
tel: 01896 826133