For the first three months after glue ear has been diagnosed, a policy of "active observation" will usually be recommended. This means that your child will receive no immediate treatment, but their condition will be monitored by your GP.
This is because more than half of all cases of glue ear will resolve within three months and there is currently no medication that shortens the length of time the symptoms last.
A wide range of medications have been tested for treating the symptoms of glue ear, including:
Evidence suggests that they either have very limited or no effectiveness in shortening the duration of symptoms and can cause side effects.
Once three months have passed, your child will be tested again to see if they still have symptoms of glue ear.
When treatment is required
If testing reveals that your child still has fluid in their ear(s), it does not necessarily mean that they will automatically benefit from treatment. This is because 9 out of 10 cases of glue ear resolve within a year.
Treatment is usually only recommended if your child has:
- hearing loss causing significant problems with their learning, development and social skills
- persistent hearing loss lasting longer than three months
- very severe hearing loss
- Down’s syndrome or a cleft palate
Unlike in most other causes, glue ear is unlikely to get better by itself in children with either of these conditions. They also have pre-existing communications difficulties that could be made worse by persistent hearing loss.
In such a circumstance you will likely be referred to your local ear, nose and throat (ENT) department for further assessment and treatment.
The two main treatment options for glue ear are:
Hearing aids
Hearing aids are often recommended for children with Down's syndrome as the results of glue ear surgery for children with Down’s syndrome can be unpredictable.
Hearing aids can also be used when your child is unable to have surgery or you are unwilling for surgery to be carried out.
A hearing aid is an electronic device that consists of:
- a microphone
- an amplifier
- a loudspeaker
- a battery
Modern hearing aids are very small and discreet, and some can be worn inside the ear. The microphone picks up sound, which is made louder by the amplifier. Hearing aids are also fitted with devices that can distinguish between background noise, such as traffic, and foreground noise, such as conversation.
Read how hearing aids can be used to treat hearing impairment.
Surgery
Surgery for glue ear usually involves a procedure uisng a piece of equipment called a grommet (grommet insertion). A grommet is a very small tube that is inserted into your child's ear through a small cut in their eardrum.
A grommet will drain away fluid in the middle ear and help to maintain the air pressure in the middle ear cavity.
A grommet insertion is performed under general anaesthetic (where the patient is unconscious). It usually only takes about 15 minutes, so your child should be able to go home the same day.
During the first few days after surgery, your child may find that noises sound much louder than they are used to. This is normal and should pass as your child gets used to having a normal level of hearing.
A grommet will help to keep the eardrum open for several months. As the eardrum starts to heal, the grommet will slowly be pushed out of the eardrum and will eventually fall out. This process happens naturally and should not be painful.
Most grommets will fall out from 9 to 15 months after being inserted. Around one child in three will need further grommets.
Watch our animation showing how surgery is performed.
Other treatments
There are several other treatments that are less commonly used to treat glue ear. These are described below.
Autoinflation
Autoinflation involves your child blowing up a special balloon using their nose. It helps to open up the Eustachian tube, which makes it easier for the tube to drain fluid from the middle ear.
Your child will need to do this regularly until all the fluid has drained away. Autoinflation can be a difficult procedure for young children to perform and is not always suitable.
If your child complains of pain during the process then you should no longer continue with this treatment.
Also, autoinflation should not be performed if your child has a cold, chest infection, throat infection or the flu.
Adenoidectomy
An adenoidectomy is the surgical removal of the adenoids.
The adenoids are soft mounds of tissue at the very back of the throat. They are part of the body’s immune system, which helps to fight infection. If your child’s adenoids are enlarged and swollen, they can sometimes block the Eustachian tube. Having them removed can help the Eustachian tube to work better.
An adenoidectomy is usually only suitable for children who are over three years old, and where there is evidence that their adenoids are contributing towards symptoms.
The procedure will be performed under general anaesthetic, and your child will usually able to go home the same day. An adenoidectomy is often performed at the same time as a grommet insertion.
