Glue Ear - Causes, Symptoms & Treatments

What is glue ear?

Glue ear is a condition that occurs when the middle part of the ear canal, which is located behind the eardrum, fills up with fluid. The upper throat and back of the nasal cavity is connected to the middle ear via a canal called the eustachian tube. With glue ear, the eustachian tube loses the ability to drain away the mucus, which builds up in the ear. This fluid can become thick and sticky, like glue, and cause complications such as hearing loss.

What are the symptoms of glue ear?

The main symptom of glue ear is temporary hearing loss, which may affect one or both ears. Other symptoms include tinnitus, which is a ringing or buzzing in the ears, and ear pain or earache. Glue ear can also cause problems with balance, and if it persists, may affect a child’s speech and language development. Signs of a hearing problem in a child can present as speaking loudly or incoherently, not responding when spoken to, becoming easily distracted in conversations or seeming to struggle with concentration, asking people to repeat what they say, or asking for the volume to be turned up on household devices.

In adults, the symptoms of glue ear are the same as children, and hearing is similarly dulled or dampened by the condition. Adults with glue ear may appear to have selective hearing and can also experience difficulty with communication or find social interaction challenging due to this hearing loss.

How is glue ear diagnosed?

Glue ear is diagnosed by a GP or a specialist such as an audiologist. They will examine their patient with a tool called an otoscope, which allows them to look into the ear canal and at the ear drum. They may also perform hearing tests, or other tests that check the condition and performance of the ear. 

What causes glue ear?

There is no definite answer to what causes glue ear, but in over half the cases it is associated with a middle ear infection, particularly in the case of young children. It follows that glue ear is usually more common in the winter months. Associated factors include environmental allergies and passive smoking, which irritate the Eustachian tube and contribute to mucus production.

Who is most at risk of glue ear?

Glue ear usually affects children but can, less commonly, present in adults. Young children are most often affected by glue ear between the ages of two and five, but it is estimated that up to one third of all glue ear sufferers are over sixteen years of age. The National Deaf Children’s Society suggest that as many as one in five pre-school children have glue ear at any one time and eight out of ten children will experience glue ear before the age of ten.

However, some people are more likely to experience glue ear. According to Dr Amanda Roestorf, head of research at autism charity Autistica, data from a recent study suggests that autistic children are 3.29 times more likely to have symptoms akin to glue ear or similar ear infections. Children with cleft palate or genetic conditions like Down Syndrome are also thought to be more at risk.

How long does glue ear last?

In many cases glue ear gets better within a few months, however the condition can persist for longer. If there are recurrent cases of glue ear, the condition may be considered serious or chronic.

How is glue ear treated?

The two main treatments of glue ear are grommets or temporary hearing aids, but sometimes a doctor may advise waiting to see if the condition will improve on its own. Occasionally antibiotics are prescribed for infections associated with or thought to have caused glue ear, but they are not usually an effective way of treating the condition.

In chronic cases, and cases where other treatments haven’t been successful, an adenoidectomy may be recommended. Adenoids are small areas of tissue in the back of the throat that, when inflamed, are thought to contribute to glue ear and Eustachian tube dysfunction. They are only usually present in children and reach their largest size between the ages of three and five.

What is a glue ear balloon and do they work?

A glue ear balloon is an autoinflation device which opens the Eustachian tubes and alleviates fluid build up. Using it involves inflating a specially pressurised balloon with each nostril, which is usually done as part of a daily routine.

Auto inflation is recommended by doctors as an effective, non-invasive method to alleviate the symptoms of glue ear.

What are grommets and do they help with ear glue?

Grommets are very small tubes which are surgically inserted into the ear drum. They may be recommended for persistent or recurring cases of glue ear.

Grommets allow air to pass through the ear drum, keeping pressure on each side equal, and helping with drainage of the collected fluid. They are inserted via a brief surgical procedure, after which the patient will usually be given antibiotic ear drops to administer at home. There are minor risks of this treatment, including infection and other general risk factors associated with any surgical procedure- it is estimated that approximately one in one hundred children develops a perforated ear drum following the insertion of grommets. However, they remain one of the most effective treatments for glue ear.

How can I avoid getting glue ear?

To avoid getting glue ear, we can avoid its common cause by taking general measures to avoid the transfer of bacteria and viruses, such as maintaining good home and personal hygiene.

Passive smoking and allergies are also thought to be contributing factors to the development of glue ear, so avoiding smoky environments and being aware of pollen, animal and dust mite allergies are strategies that could reduce the risk.

 There are exercises that can be performed, which involve vigorous swallowing and blowing the nose. Combining the two is considered effective: pinching the nose while swallowing and continuing to blow the nose will open the Eustachian tubes and allow air into the middle ear. These exercises are sometimes called middle ear aeration.

For babies and infants it is noted that breast milk provides beneficial immune support which may help protect them against glue ear. It is also recommended to feed babies in an upright position to reduce the possibility of fluid entering their Eustachian tubes.

Can I fly with glue ear?

It is recommended to speak to your GP before flying with glue ear. They may prescribe a decongestant or advise delaying your trip, based on their assessment of your ear health.

The changes in pressure in the cabin during take-off and landing can cause expansion to the fluid in the middle ear, which can cause discomfort. There is some risk of a perforated eardrum, which usually does not cause long term damage. However, according to the National Deaf Children’s Society, children with glue ear generally don’t experience problems flying.

Things you can do to reduce discomfort when flying with glue ear include eating or drinking during landing and take-off, performing middle ear aeration or auto inflation techniques, or by using special ear plugs designed for air travel.

Can ear wax removal help with glue ear?

Symptoms associated with ear wax issues may present similarly to glue ear, but they are different conditions, and require different treatments. Ear wax build up can also cause hearing loss, ear pain (ear ache), tinnitus, issues with balance and ear infections. Ear wax is removed via processes such as microsuction, which involves the gentle dislodging and removal of wax from the ear canal.

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