Glue Ear

 Glue ear is very common in children in the first five years of life.  At any one time one in five children of this age will have glue ear particularly if there is a family history or personal history of allergy.  Most children with glue ear will not get significant symptoms and therefore do not require treatment, only monitoring.

 How glue ear comes about

What happens in glue ear is that enlarged adenoids and excessive secretions at the back of the throat cause blockage of the Eustachian tube.  The air in the middle ear then gets absorbed and is replaced with sticky fluid (the glue of glue ear).  In this situation the tympanic membrane is retracted and quite often swollen and inflamed.  The fluid in the middle ear can act as a culture medium so just one bacterium there will grow rapidly and white cells will come in to attack the bacteria.  As the pus builds up the negative pressure then becomes positive and the ear becomes extremely painful.  Without antibiotic treatment there may be a tympanic rupture after which the pain is greatly eased.

 Symptoms

The sort of symptoms that would make you consider treatment are problems with speech development, problems with hearing, problems with balance, and pain and discomfort in the ear which may lead to behaviour disturbance (this can be difficult to be sure of objectively).  The other indication is recurrent ear infections particularly if these lead to perforation.

 Treatment 

Initially it may be enough to asses the effect of removing diary products and the use of a homeopathic treatment and Otovent.

Thereafter a a two month course of low dose antibiotic, such as Amoxycillin taken once a day 125 mg orally, and Flixonase taken one snort to each nostril once a day also may be assesed.

If this is unsuccessful then referral may be made to an ENT surgeon for consideration of insertion of grommets and adenoidectomy.  Before embarking on treatment however it is important to ascertain whether the glue ear is causing any significant symptoms and to appreciate that although the immediate effect of grommet insertion under GA may be very dramatic there is little difference between  treated and non treated ear within 3 months..

When to call us

 If you feel that your child‘s glue ear is causing any of the following

1 Delayed speech

2 Behaviour disorder – it can be very disorientating to have only partial hearing

3 Balance problems.

4 Recurrent ear infections – especially with tympanic membrane rupture

5 Poor hearing – either noticed at home or on formal hearing testing.